THOMAS M WALLACE


Address: 1441 Florida Ave, Modesto, CA 95350-4405
Phone: 2095763525

THOMAS M WALLACE (NPI# 1679641666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679641666
Entity Type Individual
Full Name THOMAS M WALLACE
Credential M.D.
Practice Address 1441 Florida Ave
Modesto
CA 95350-4405
Practice Telephone 2095763525
Practice Fax Number 2095763544
Mailing Telephone 2095763525
Mailing Fax Number 2095763544
Enumeration Date 2006-11-30
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
G42269 CA Allopathic & Osteopathic Physicians

Other Providers THOMAS WALLACE

NPI Name Taxonomy Address Enumeration
1124021696 Thomas R Wallace Ophthalmology 211 Mcauley Ct, Hot Springs, AR 71913-6314 2005-05-27
1316547342 Thomas E Wallace IIi Pharmacist 1571 Forest Ave, Staten Island, NY 10302-2226 2020-10-28
1023499217 Thomas Wallace Massage Therapist 17205 Vashon Hwy Sw, Suite B2, Vashon, WA 98070-4674 2015-06-12
1275945354 Thomas Wallace Jr. Counselor 1646 S Court St, Visalia, CA 93277-4962 2014-05-23
1265787147 Thomas Danville Wallace Pharmacy Technician 215 Dexter L Woods Memorial Blvd, Waynesboro, TN 38485-2416 2012-07-17
1386789147 Thomas W Wallace Psychiatry & Neurology 180 Grand Ave Ste 100, Oakland, CA 94612-3766 2007-02-20
1801942933 Thomas Clyde Wallace Psychiatry & Neurology 10 Congress St, Suite 360, Pasadena, CA 91105-3023 2007-01-25
1295807733 Thomas Witherspoon Wallace Internal Medicine 10100 Kanis Rd, Little Rock, AR 72205-6202 2006-11-13
1639251416 Thomas A Wallace Social Worker 254 N Washington St, Falls Church, VA 22046-4517 2006-10-20
1811089006 Thomas K Wallace Nurse Anesthetist, Certified Registered 800 E 28th St, Minneapolis, MN 55407-3723 2006-09-28

Office Location

Street Address 1441 FLORIDA AVE
City MODESTO
State CA
Zip Code 95350-4405

Providers in the same location

NPI Name Taxonomy Address Enumeration
1326044876 Suhail Rahhal Internal Medicine 1441 Florida Ave, Modesto, CA 95350-4404 2005-06-21
1629603667 Avinesh Prakash Nurse Practitioner 1441 Florida Ave, Modesto, CA 95350-4404 2020-03-10
1437784469 Jose L Bazan Nurse Practitioner 1441 Florida Ave, Modesto, CA 95350-4404 2020-03-10
1770117541 Sydney Edwards Physician Assistant 1441 Florida Ave, Modesto, CA 95350-4418 2020-03-02
1003466756 Jessica Izelle Whipkey Pharmacy Technician 1441 Florida Ave, Modesto, CA 95350-4418 2019-09-16
1538715040 Antoinette Marie Nguyen Registered Nurse 1441 Florida Ave, Modesto, CA 95350-4404 2019-08-12
1588229637 Janel Mark Perfusionist 1441 Florida Ave, Modesto, CA 95350-4404 2019-05-03
1437713799 Kunal Panwar Student in an Organized Health Care Education/Training Program 1441 Florida Ave, Modesto, CA 95350-4404 2019-04-23
1275196099 Billy Huynh Student in an Organized Health Care Education/Training Program 1441 Florida Ave, Modesto, CA 95350-4418 2019-04-17
1063075067 Herbert Mao Student in an Organized Health Care Education/Training Program 1441 Florida Ave, Modesto, CA 95350-4404 2019-04-16
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164020459 Karina Montes Rodriguez Case Manager/Care Coordinator Cip 1540 Florida Ave, Suite 212, Modesto, CA 95350 2020-10-09
1134737315 Dr. Jeffrey A. Saladin, Dental Corporation Dentist 2057 Tully Road, Suite A, Modesto, CA 95350 2020-07-14
1588211254 Karla Junuen Toscano Licensed Vocational Nurse 1235 Mchenry Ave. Suites A&b, Modesto, CA 95350 2019-08-19
1831694769 Loretta Myers-weber Nurse Practitioner 1510 Florida Ave Ste A, Modesto, CA 95350 2018-03-23
1720599632 Coral Alejandra Amador Counselor 1700 Mchenry Village Way, Suite 11b, Modesto, CA 95350 2017-10-18
1053820522 Pannu and Henne Dental Corp. Dentist 3219 Mc Henry Ave, Suite E, Modesto, CA 95350 2017-09-27
1346779709 Kevin Sotelo Behavior Technician 2630 W Rumble Road, Modesto, CA 95350 2017-06-08
1255869566 Hoa Xuan Phan Family Medicine 1441 Florida Ave Ste 200, Modesto, CA 95350 2017-05-31
1356881163 Brady S Marshall Dentist 201 E. Orangeburg Avenue, Suite C, Modesto, CA 95350 2017-02-27
1750755476 Caremore Health Plan Nurse Practitioner 1234 Mchenry Avenue, Modesto, CA 95350 2015-11-18
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Taxonomy Information

Taxonomy Code 207RC0200X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Critical Care Medicine

Taxonomy Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1649660937 Aashir Shah Internal Medicine 600 Coffee Rd, Modesto, CA 95355 2015-01-26
1568752889 Prachi P Vishwasrao Internal Medicine 600 Coffee Rd, Modesto, CA 95355-4201 2011-04-08
1699089557 Ylaine Rose Tupas Aldeguer Internal Medicine 600 Coffee Rd, Modesto, CA 95355-4201 2010-08-03
1467695718 Walid Salihi Internal Medicine 600 Coffee Rd, Modesto, CA 95355-4201 2009-04-16
1750587101 Rim Atoui Internal Medicine 600 Coffee Rd, Modesto, CA 95355-4201 2007-06-22
1366510356 Pietro G Pecci Internal Medicine 1441 Florida Ave, Modesto, CA 95350-4405 2006-11-30
1487602819 Manjit Singh Dhillon Internal Medicine 700 17th St, Modesto, CA 95354-1247 2006-05-05
1235190760 Roger E Elias Internal Medicine 600 Coffee Rd, Modesto, CA 95355-4201 2006-04-02
1538134374 Amr F Al-bacil Internal Medicine 600 Coffee Rd, Modesto, CA 95355 2006-02-22
1275517070 Samuel Sumpter Baker Internal Medicine 1401 Spanos Court, Suite 230, Modesto, CA 95355-2816 2005-12-05
Find all providers in MODESTO

Competitor

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City MODESTO
Zip Code 95350

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Dataset Information

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.

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