AUSTIN WALLACE (NPI# 1831754209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831754209 |
| Entity Type | Individual |
| Full Name | AUSTIN WALLACE |
| Credential | RSLD |
| Practice Address |
2138 N Tustin St Orange CA 92865-3712 |
| Mailing Address |
11605 N Lamar Blvd Austin TX 78753-2658 |
| Practice Telephone | 7144504487 |
| Practice Fax Number | 7146370020 |
| Mailing Telephone | 7372226996 |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-05-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
5200 | CA | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952864308 | Austin H Wallace | Physician Assistant | 8080 Bluebonnet Blvd Ste 1000, Baton Rouge, LA 70810-7827 | 2019-04-12 |
| 1063901023 | Austin William Wallace | Student in an Organized Health Care Education/Training Program | 3450 Hull Rd, Gainesville, FL 32607-4144 | 2018-05-05 |
| 1437356193 | Austin Fisher Wallace | Anesthesiology | 1010 Three Springs Blvd, Suite 294, Durango, CO 81301-8296 | 2007-06-27 |
| Street Address |
2138 N TUSTIN ST |
| City | ORANGE |
| State | CA |
| Zip Code | 92865-3712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972548873 | Garfield Beach Cvs LLC | Pharmacy | 2138 N Tustin St, Orange, CA 92865-3712 | 2006-06-17 |
| 1669037032 | Gladys Servin De La Mora | Technician/Technologist | 2138 N Tustin St, Orange, CA 92865-3712 | 2019-05-01 |
| 1427613884 | John Kawecki | Technician/Technologist | 2138 N Tustin St, Orange, CA 92865-3712 | 2019-05-01 |
| 1518520824 | Susan Mijin Cho | Pharmacist | 2138 N Tustin St, Orange, CA 92865-3712 | 2019-04-22 |
| 1356845960 | Elena Galletto | Pharmacist | 2138 N Tustin St, Orange, CA 92865-3712 | 2018-03-19 |
| 1700241700 | Hang Huynh | Pharmacist | 2138 N Tustin St, Orange, CA 92865-3712 | 2015-12-18 |
| 1952775116 | Jeff Dai | Pharmacist | 2138 N Tustin St, Orange, CA 92865-3712 | 2015-11-25 |
| 1912371873 | Farideh Zonouzi | Pharmacist | 2138 N Tustin St, Orange, CA 92865-3712 | 2015-11-16 |
| 1164895207 | Gary James Greco | Pharmacist | 2138 N Tustin St, Orange, CA 92865-3712 | 2015-11-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801366489 | Kathryn Enslow | Behavior Technician | 3111 N. Tustin St. #100, Orange, CA 92865 | 2018-11-27 |
| 1992285167 | Victoria Barrientes | Behavior Technician | 3111 N. Tustiv Ave #100, Tustin, CA 92865 | 2018-08-17 |
| 1003263310 | Zhihong Acupuncture Clinic Co | Clinic/Center | 2950 N Glassell St, Suite B, Orange, CA 92865 | 2016-05-17 |
| 1962879387 | Charles C. Park D.d.s. A Professional Corporation | Dentist | 1518 E. Lincoln Ave., Orange, CA 92865 | 2015-09-02 |
| 1275913535 | David M. Datu | Dentist | 1107 E. Lincoln Ave, #201, Orange, CA 92865 | 2015-06-02 |
| 1114107505 | Life Hearing Inc. | Hearing Instrument Specialist | 1635 E. Lincoln Ave., Orange, CA 92865 | 2007-11-14 |
| 1013118488 | David M Datu Dds | Dentist | 1107 E Lincoln Ave, Suite #201, Orange, CA 92865 | 2007-05-31 |
| 1831222611 | Amini Dental Corporation | Dentist | 1916 N Tustin St, Orange, CA 92865 | 2007-03-13 |
| 1598811341 | Linda Rose Cook | Counselor | 202 W Lincoln Ave, Suite F, Orange, CA 92865 | 2007-01-26 |
| 1467525543 | Hee S Kwon | Acupuncturist | 1516 E Lincoln Ave, Orange, CA 92865 | 2006-11-16 |
| Find all providers in zip 92865 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477069730 | Cvs Aoc Corporation | Technician/Technologist | 2138 N Tustin St # 9749, Orange, CA 92865-3712 | 2017-12-22 |
| 1023547619 | National Vision. Inc. | Technician/Technologist | 970 N Tustin St Ste A, Orange, CA 92867-5967 | 2017-06-07 |
| 1669037032 | Gladys Servin De La Mora | Technician/Technologist | 2138 N Tustin St, Orange, CA 92865-3712 | 2019-05-01 |
| 1427613884 | John Kawecki | Technician/Technologist | 2138 N Tustin St, Orange, CA 92865-3712 | 2019-05-01 |
| 1083022339 | Weverton Depaula | Technician/Technologist | 240 Indian River Rd, C-3, Orange, CT 06477-3649 | 2014-07-31 |
| 1548670094 | Veo Vision Center, LLC | Technician/Technologist | 240 Indian River Rd, C-3, Orange, CT 06477-3649 | 2014-05-06 |
| 1700152642 | Sylvia Dale Bickham | Technician/Technologist | 1502 Strickland Dr Ste 2, Orange, TX 77630 | 2012-03-26 |
| 1417199183 | Hiep Q Dinh | Technician/Technologist | 2836 E Chapman Ave, Orange, CA 92869-3200 | 2009-03-27 |
| 1225288095 | Douglas J Dupell | Technician/Technologist | 119 New Athol Rd, Orange, MA 01364-9603 | 2008-09-29 |
| 1235389008 | William M Grant | Technician/Technologist | 119 New Athol Rd, Orange, MA 01364-9603 | 2008-09-29 |
| Find all providers in ORANGE | ||||
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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.