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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
G42269 | CA | Allopathic & Osteopathic Physicians |
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 |
Street Address |
1441 FLORIDA AVE |
City | MODESTO |
State | CA |
Zip Code | 95350-4405 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 95350 |
Taxonomy Code | 207RC0200X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Critical Care Medicine |
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. |
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 |
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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.