DAVID ALAN WALLACE (NPI# 1679576276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679576276 |
| Entity Type | Individual |
| Full Name | DAVID ALAN WALLACE |
| Credential | M.D. |
| Practice Address |
11600 Wilshire Blvd Ste 200 Los Angeles CA 90025-1782 |
| Practice Telephone | 3108282020 |
| Practice Fax Number | 3109143009 |
| Mailing Telephone | 3108282020 |
| Mailing Fax Number | 3109143009 |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2010-04-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | G37076 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CA MEDICAL LICENSE | G37076 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700327061 | David Wallace | Student in an Organized Health Care Education/Training Program | 24606 Mosquero Ln, Mission Viejo, CA 92691-4913 | 2017-03-19 |
| 1265743595 | David R Wallace Jr. | Radiology | 200 W Arbor Dr # Mc0834, Department of Radiology, San Diego, CA 92102-0834 | 2010-07-01 |
| 1386868487 | David Stuart Wallace | Chiropractor | 2330 Highway 94 South Outer Rd, Saint Charles, MO 63303-8301 | 2007-04-12 |
| 1649343641 | David Michael Wallace | Chiropractor | 112 W Grand Ave, Rainbow City, AL 35906-3233 | 2006-11-16 |
| 1932193604 | David Wallace | Anesthesiology | 738 Golden Pheasant Dr, Draper, UT 84020-8454 | 2005-09-08 |
| 1386646206 | David Allen Wallace | Dentist | 206 S Walker St, Princeton, WV 24740-2747 | 2005-08-11 |
| 1295736809 | David B. Wallace | Radiology | 325 N Highland Ave, Provena Mercy Medical Center, Aurora, IL 60506-3811 | 2005-08-04 |
| 1619596335 | David Alexander Wallace | Student in an Organized Health Care Education/Training Program | 920 Madison Ave Ste 447, Memphis, TN 38103-3438 | 2020-04-13 |
| 1396364402 | David Carter Wallace | Student in an Organized Health Care Education/Training Program | 620 Shadow Ln, Las Vegas, NV 89106-4119 | 2020-04-09 |
| 1720646672 | David Wallace | Physician Assistant | 1 Hospital Plz, Stamford, CT 06902-3602 | 2019-06-04 |
| Street Address |
11600 WILSHIRE BLVD STE 200 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90025-1782 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205373198 | Premier Healthcare and Supplies | Durable Medical Equipment & Medical Supplies | 11600 Wilshire Blvd, Los Angeles, CA 90025-5781 | 2017-01-30 |
| 1376092213 | Balestrieri Psychological Services, P.C. | Psychologist | 11600 Wilshire Blvd, Suite 412, Los Angeles, CA 90025-5781 | 2016-10-03 |
| 1982055489 | Best Health Corp | Internal Medicine | 11600 Wilshire Blvd, Suite 12, Los Angeles, CA 90025-5781 | 2016-06-26 |
| 1871979013 | Anna Kreymer | Dentist | 11600 Wilshire Blvd, Suite 10, Los Angeles, CA 90025-5781 | 2015-08-10 |
| 1811387723 | West Wilshire Family Medical Center | Clinic/Center | 11600 Wilshire Blvd, Suite 416, Los Angeles, CA 90025-5781 | 2015-01-30 |
| 1336543917 | Dr. Steven Rosenblatt | Acupuncturist | 11600 Wilshire Blvd, Suite 320, Los Angeles, CA 90025-5781 | 2014-10-10 |
| 1952643223 | Wendy Choy | Optometrist | 11600 Wilshire Blvd, Suite 100, Los Angeles, CA 90025-5781 | 2013-03-25 |
| 1942546742 | Russell Francis Moon | Dentist | 11600 Wilshire Blvd, #10, Los Angeles, CA 90025-5781 | 2012-12-25 |
| 1841543873 | Anne R Meyer Md A Professional Corporation | Physical Medicine & Rehabilitation | 11600 Wilshire Blvd, Suite 412, Los Angeles, CA 90025-5781 | 2012-10-15 |
| 1083985451 | Pacific Coast Sports Medicine | Chiropractor | 11600 Wilshire Blvd, Suite 522, Los Angeles, CA 90025-5781 | 2012-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962324 | Marjan-marcia Khalitchi-alavi | Psychologist | 12400 Wilshire Blvd #230, Los Angeles, CA 90025 | 2020-11-06 |
| 1245852599 | Maureen Bridget Mcglynn | Marriage & Family Therapist | 1531 Purdue Avenue, Los Angeles, CA 90025 | 2020-05-09 |
| 1578118857 | Gregory J Bogie | Physical Therapist | 10351 Santa Monica Blvd. Suite 101, Los Angeles, CA 90025 | 2019-08-05 |
| 1518527712 | David Allen Goldstein | Marriage & Family Therapist | 12301 Wilshire Blvd., Suite 515, Los Angeles, CA 90025 | 2019-06-19 |
| 1386104875 | Kevin Meir Youssefzadeh | Student in an Organized Health Care Education/Training Program | 304 Dowlen Dr, Los Angeles, CA 90025 | 2019-03-21 |
| 1336609189 | Psychotherapy Center for Healing and Personal Growth | Psychologist | 2001 S. Barington Ave Suite 222, Los Angeles, CA 90025 | 2019-03-20 |
| 1477028819 | Flora Ma | Nurse Practitioner | 1726 Purdue Ave, Apt 2, Los Angeles, CA 90025 | 2018-10-12 |
| 1457834285 | Yeesul Yoo | Chiropractor | 2001 S. Barrington Ave Suite 101, Los Angeles, CA 90025 | 2018-09-07 |
| 1902387160 | Angelica Carmen Regalado | Behavior Technician | 7400 Pacific Blvd. Suite A & B, Walnut Park, CA 90025 | 2018-08-26 |
| 1033603378 | Craig Allen Gillett | Marriage & Family Therapist | 11847 Wilshire Blvd., #300, Los Angeles, CA 90025 | 2018-06-20 |
| Find all providers in zip 90025 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407473754 | Janet K. Kim Md, Inc | Ophthalmology | 903 Crenshaw Blvd Ste 105, Los Angeles, CA 90019-1972 | 2020-07-02 |
| 1770048266 | Luxi Optometry, Inc | Ophthalmology | 3250 W. Olympic Blvd #221, Los Angeles, CA 90006 | 2019-02-08 |
| 1598238784 | Stanley S Kim Md, Inc | Ophthalmology | 3663 W 6th St Ste 200, Los Angeles, CA 90020-3048 | 2019-01-10 |
| 1811462542 | Eyecare Specialists Medical Group, Inc | Ophthalmology | 5120 W Goldleaf Cir Ste 20, Los Angeles, CA 90056-1292 | 2018-10-09 |
| 1386132744 | Masket Foundation Clinic for Eye Care | Ophthalmology | 2080 Century Park E Ste 911, Los Angeles, CA 90067-2012 | 2018-05-01 |
| 1922501154 | Maloney-shamie Vision Institute | Ophthalmology | 10921 Wilshire Blvd Ste 900, Los Angeles, CA 90024-4003 | 2018-03-14 |
| 1417484213 | Julie You Kwon Md Inc | Ophthalmology | 932 S Cloverdale Ave, Los Angeles, CA 90036-4817 | 2017-05-11 |
| 1932581642 | Eric Shieh | Ophthalmology | 100 Stein Plz Rm 2-132, Los Angeles, CA 90095-7065 | 2015-06-18 |
| 1275950115 | Daniel Lemor | Ophthalmology | 4036 Whittier Blvd Ste 202, Los Angeles, CA 90023 | 2014-03-27 |
| 1659705705 | Martin James Brickman | Ophthalmology | 2531 Mount Beacon Ter, Los Angeles, CA 90068-2444 | 2013-08-26 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90025 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.