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D A Wallace Md Inc
Clinic/Center in Los Angeles, California
NPI 1700105491

D A Wallace Md Inc is a Clinic/Center based in Los Angeles, CA. D A Wallace Md Inc practices in Los Angeles, CA. The NPI Number for D A Wallace Md Inc is 1700105491 and holds a License No. (California).

The current practice location address for D A Wallace Md Inc is 11600 Wilshire Blvd., Los Angeles, CA and can be reached out via phone at 310-828-2020 and via fax at 310-914-3009.

Location: 11600 Wilshire Blvd., Los Angeles, CA, 90025-1782
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1700105491
Provider Name
D A Wallace Md Inc
Credential
Provider Entity Type
Organization
Address
11600 Wilshire Blvd., Los Angeles, CA, 90025-1782
Phone Number
310-828-2020
Fax Number
310-914-3009
Provider Enumeration Date
05/20/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
11600 Wilshire Blvd.
City
Los Angeles
State
California
Zip
90025-1782
Phone Number
310-828-2020
Fax Number
310-914-3009
person
Provider Business Mailing Address Details
Address
11600 Wilshire Blvd.
City
Los Angeles
State
California
Zip
90025-1782
Phone Number
310-828-2020
Fax Number
310-914-3009
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
()
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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