Daniel G Wallace (NPI# 1184656860, PAC ID# 0648376806) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1184656860 |
| PAC ID by PECOS | 0648376806 |
| Professional Enrollment ID | I20070503000597 |
| Full Name | Daniel G Wallace |
| Organization Legal Name | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| Address |
3875 Avocado Blvd La Mesa CA 91941-7303 |
| Phone Number | 6195285000 |
| Gender | M |
| Credential | MD |
| Medical School | LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE |
| Graduation Year | 1989 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 6002729175 |
| Number of Group Practice Members | 7666 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 3875 Avocado Blvd, La Mesa, CA 91941-7303 | 6195285000 | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| 4647 Zion Ave, San Diego, CA 92120-2507 | 6195285000 | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| Organization Legal Name | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| Physicians | 10172 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chengjie Zheng | Ophthalmology | Southern California Permanente Medical Group | 9449 Imperial Hwy, Downey, CA 90242-2814 |
| Dong Joo Kim | Dermatology | Southern California Permanente Medical Group | 3401 S Harbor Blvd, Santa Ana, CA 92704-7933 |
| Terese S Bergheim | Dermatology | Southern California Permanente Medical Group | 12100 Euclid St, Garden Grove, CA 92840-3304 |
| Nabeel Rashid Hameed | Family Medicine | Southern California Permanente Medical Group | 4949 Market St, Ventura, CA 93003-7851 |
| Linda Marie Silver | Clinical Social Worker | Southern California Permanente Medical Group | 2081 Palos Verdes N Dr, Lomita, CA 90717-3701 |
| Erik James Ryo Murata | Physical Therapy | Southern California Permanente Medical Group | 411 N Lakeview Ave, Anaheim, CA 92807-3028 |
| Natasha D Irving | Obstetrics/gynecology | Southern California Permanente Medical Group | 1200 Discovery Dr, Bakersfield, CA 93309-7032 |
| May Sanguanlosit | Optometry | Southern California Permanente Medical Group | 27201 Tourney Rd, Santa Clarita, CA 91355-1854 |
| Neepa Shah | Ophthalmology | Southern California Permanente Medical Group | 75036 Gerald Ford Dr, Palm Desert, CA 92211-2080 |
| Gabrielle E Brown | Dermatology | Southern California Permanente Medical Group | 18600 S Figueroa St, Gardena, CA 90248-4505 |
| Street Address |
3875 AVOCADO BLVD |
| City | LA MESA |
| State | CA |
| Zip | 91941-7303 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bashir A Rawi | Family Medicine | Southern California Permanente Medical Group | 3875 Avocado Blvd, La Mesa, CA 91941-7303 |
| Matthew E Guest | Family Medicine | Southern California Permanente Medical Group | 3875 Avocado Blvd, La Mesa, CA 91941-7303 |
| Katherine Elizabeth Oakley | General Practice | Southern California Permanente Medical Group | 3875 Avocado Blvd, La Mesa, CA 91941-7303 |
| Boyle Park | Internal Medicine | Southern California Permanente Medical Group | 3875 Avocado Blvd, La Mesa, CA 91941-7303 |
| Joanne P Mo | Family Medicine | Southern California Permanente Medical Group | 3875 Avocado Blvd, La Mesa, CA 91941-7303 |
| Jay P Mongiardo | Family Medicine | Southern California Permanente Medical Group | 3875 Avocado Blvd, La Mesa, CA 91941-7303 |
| Seth M Revels | Family Medicine | Southern California Permanente Medical Group | 3875 Avocado Blvd, La Mesa, CA 91941-7303 |
| Joanna L Gunn | Internal Medicine | Southern California Permanente Medical Group | 3875 Avocado Blvd, La Mesa, CA 91941-7303 |
| Mary C Krewsun | Physician Assistant | Southern California Permanente Medical Group | 3875 Avocado Blvd, La Mesa, CA 91941-7303 |
| Maria Lourdes C Salinas | Family Medicine | Southern California Permanente Medical Group | 3875 Avocado Blvd, La Mesa, CA 91941-7303 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jay Gerzmehle | Occupational Therapy | Sharp Rees-stealy Medical Group Inc | 7862 El Cajon Blvd, La Mesa, CA 91941 |
| Rhad Armstrong Brown | Physical Therapy | Sharp Rees-stealy Medical Group Inc | 7862 El Cajon Blvd, La Mesa, CA 91941 |
| Jennifer N Tam | Optometry | Sharp Rees-stealy Medical Group Inc | 7862 El Cajon Blvd, La Mesa, CA 91941 |
| Sheri Suzanne Smith | Qualified Speech Language Pathologist | Sharp Rees-stealy Medical Group Inc | 7862 El Cajon Blvd, La Mesa, CA 91941 |
| Annie Tsuen Chin | Optometry | Sharp Rees-stealy Medical Group Inc | 7862 El Cajon Blvd, La Mesa, CA 91941 |
| Megan La Greca Meduna | Physical Therapy | Sharp Rees-stealy Medical Group Inc | 7862 El Cajon Blvd, La Mesa, CA 91941 |
| Stewart E Sanders | Physical Therapy | Sharp Rees-stealy Medical Group Inc | 7862 El Cajon Blvd, La Mesa, CA 91941 |
| Phaysane Oudom | Physical Therapy | Sharp Rees-stealy Medical Group Inc | 7862 El Cajon Blvd, La Mesa, CA 91941 |
| Craig C Liu | Optometry | Sharp Rees-stealy Medical Group Inc | 7862 El Cajon Blvd, La Mesa, CA 91941 |
| Stephanie Danielle Stone | Physical Therapy | Sharp Rees-stealy Medical Group Inc | 7862 El Cajon Blvd, La Mesa, CA 91941 |
| Find all physicians in zip 91941 | |||
| City | LA MESA |
| Zip Code | 91941 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | LA MESA + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Daniel G Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.