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Eric Wallace, MD
Diagnostic Radiology Physician in Ventura, California
NPI 1578502191

Eric Wallace is a Diagnostic Radiology Physician based in Simi Valley, CA and is specialized in Diagnostic Radiology. Eric Wallace practices in Ventura, CA and has the professional credentials of MD. The NPI Number for Eric Wallace is 1578502191 and holds a License No. A85195 (California).

The current practice location address for Eric Wallace is 168 N Brent St, Ventura, CA and can be reached out via phone at 888-234-0004 and via fax at 805-641-3965.

Location: 168 N Brent St, Ventura, CA, 93063-6721
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1578502191
Provider Name
Eric Wallace
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
168 N Brent St, Ventura, CA, 93063-6721
Phone Number
888-234-0004
Fax Number
805-641-3965
Provider Enumeration Date
06/06/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00A851950 01 CA BLUESHIELD OF CA
00A851950 05 CA
institution
Provider Business Practice Location Address Details
Address
168 N Brent St
City
Ventura
State
California
Zip
93003-2817
Phone Number
888-234-0004
Fax Number
805-641-3965
person
Provider Business Mailing Address Details
Address
168 N Brent St
City
Ventura
State
California
Zip
93003-2817
Phone Number
888-234-0004
Fax Number
805-641-3965
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
A85195 (California)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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