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Dr. Brandon M Wallace, DPM
Foot & Ankle Surgery Podiatrist in Los Angeles, California
NPI 1316426679

Brandon M Wallace is a Foot & Ankle Surgery Podiatrist based in Los Angeles, CA and is specialized in Foot & Ankle Surgery. Brandon M Wallace practices in Los Angeles, CA and has the professional credentials of DPM. The NPI Number for Brandon M Wallace is 1316426679 and holds a License No. E5705 (California).

The current practice location address for Brandon M Wallace is 1701 E Cesar E Chavez Ave Ste 510, Los Angeles, CA and can be reached out via phone at 323-269-5205.

Location: 1701 E Cesar E Chavez Ave Ste 510, Los Angeles, CA, 90033-2414
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316426679
Provider Name
Brandon M Wallace
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
1701 E Cesar E Chavez Ave Ste 510, Los Angeles, CA, 90033-2414
Phone Number
323-269-5205
Fax Number
Provider Enumeration Date
08/08/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1701 E Cesar E Chavez Ave Ste 510
City
Los Angeles
State
California
Zip
90033-2488
Phone Number
323-269-5205
Fax Number
person
Provider Business Mailing Address Details
Address
1701 E Cesar E Chavez Ave Ste 510
City
Los Angeles
State
California
Zip
90033-2488
Phone Number
323-269-5205
Fax Number
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
213ES0103X
License No.
E5705 (California)
Definition
Definition to come...
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