Wallis, David

Wallis, David is an sole proprietor health care provider with primary practice located at 520 N Prospect Ave Ste 309 , Redondo Beach CA 90277-3043. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Wallis, David can be contacted via phone (424) 437-4700.

Contact Information

Primary practice address
520 N Prospect Ave Ste 309 Redondo Beach CA 90277-3043
Phone: (424) 437-4700
Fax: (424) 437-8884
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A77627 California

Profile Details

NPI number 1255383139
LBN Legal business name Wallis, David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 17th, 2006
Last updated Apr 13th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255383139 NPPES
California Other 00A776270 BLUE SHIELD

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