William Dean Wallace (NPI# 1245269943, PAC ID# 4082648860) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PATHOLOGY.
| Nation Provider ID (NPI) | 1245269943 |
| PAC ID by PECOS | 4082648860 |
| Professional Enrollment ID | I20050921000500 |
| Full Name | William Dean Wallace |
| Organization Legal Name | USC CARE MEDICAL GROUP INC |
| Address |
2011 Zonal Ave Hmr Suite 308 Los Angeles CA 90033-0110 |
| Phone Number | 6264452300 |
| Gender | M |
| Credential | MD |
| Medical School | RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY |
| Graduation Year | 2000 |
| Primary Specialty | PATHOLOGY |
| Group Practice PAC ID | 0446157747 |
| Number of Group Practice Members | 962 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050696 | KECK HOSPITAL OF USC |
| 050262 | RONALD REAGAN U C L A MEDICAL CENTER |
| 050112 | SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL |
| 050660 | USC KENNETH NORRIS JR CANCER HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 10833 Le Conte Ave, Los Angeles, CA 90095-3075 | UCLA PATHOLOGY AND LABORATORY MEDICINE GROUP | |
| 1441 Eastlake Ave, Suite 2424, Los Angeles, CA 90089-0112 | 3234422582 | USC CARE MEDICAL GROUP INC |
| 1500 San Pablo St, Los Angeles, CA 90033-5313 | USC CARE MEDICAL GROUP INC | |
| 1516 San Pablo St, Los Angeles, CA 90033-5313 | 8008722273 | USC CARE MEDICAL GROUP INC |
| 1520 San Pablo St, Los Angeles, CA 90033-5310 | 8008722273 | USC CARE MEDICAL GROUP INC |
| 1520 San Pablo St, Fl 4, Los Angeles, CA 90033-5310 | 8008722273 | USC CARE MEDICAL GROUP INC |
| 1520 San Pablo St 1st Floor N, Los Angeles, CA 90033-5310 | 8008722273 | USC CARE MEDICAL GROUP INC |
| 2011 Zonal Ave Hmr, Suite 308, Los Angeles, CA 90033-0110 | 6264452300 | USC CARE MEDICAL GROUP INC |
| 5900 W Olympic Blvd, Los Angeles, CA 90036-4671 | 3102672680 | UCLA PATHOLOGY AND LABORATORY MEDICINE GROUP |
| Organization Legal Name | USC CARE MEDICAL GROUP INC |
| Physicians | 1070 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa Duong Tan | Physical Therapy | Usc Care Medical Group Inc | 1640 Marengo St, Los Angeles, CA 90033-1036 |
| Chelsea Kay Cole | Qualified Audiologist | Usc Care Medical Group Inc | 806 W Adams Blvd, Los Angeles, CA 90007-2505 |
| Burton L Eisenberg | Surgical Oncology | Usc Care Medical Group Inc | 1520 San Pablo St, Los Angeles, CA 90033-5310 |
| Paul C Lee | Interventional Pain Management | Usc Care Medical Group Inc | 1520 San Pablo St 1st Floor N, Los Angeles, CA 90033-5310 |
| Manju Aron | Pathology | Usc Care Medical Group Inc | 1500 San Pablo St, Los Angeles, CA 90033-5313 |
| Caroline Hwang | Gastroenterology | Usc Care Medical Group Inc | 1450 San Pablo St, Los Angeles, CA 90033-4500 |
| Clan H Hahn | Hematology/oncology | Usc Care Medical Group Inc | 1225 Wilshire Blvd, Los Angeles, CA 90017-1901 |
| Eric Allan White | Diagnostic Radiology | Usc Care Medical Group Inc | 830 S Flower St, Suite B100, Los Angeles, CA 90017-4608 |
| Andy E Sherrod | Pathology | Usc Care Medical Group Inc | 2011 Zonal Ave Hmr, Suite 308, Los Angeles, CA 90033-0110 |
| David T Woodley | Dermatology | Usc Care Medical Group Inc | 120 Bellefontaine St, Pasadena, CA 91105-3102 |
| Street Address |
2011 ZONAL AVE HMR SUITE 308 |
| City | LOS ANGELES |
| State | CA |
| Zip | 90033-0110 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andy E Sherrod | Pathology | Usc Care Medical Group Inc | 2011 Zonal Ave Hmr, Suite 308, Los Angeles, CA 90033-0110 |
| Ashley Satsuki Hagiya | Pathology | Usc Care Medical Group Inc | 2011 Zonal Ave Hmr, Suite 308, Los Angeles, CA 90033-0110 |
| Shivani R Kandukuri | Pathology | Usc Care Medical Group Inc | 2011 Zonal Ave Hmr, Suite 308, Los Angeles, CA 90033-0110 |
| Shefali Chopra | Pathology | Usc Care Medical Group Inc | 2011 Zonal Ave Hmr, Suite 308, Los Angeles, CA 90033-0110 |
| Michael Koss | Pathology | Usc Care Medical Group Inc | 2011 Zonal Ave Hmr, Suite 308, Los Angeles, CA 90033-0110 |
| Sergei K Tatishchev | Pathology | Usc Care Medical Group Inc | 2011 Zonal Ave Hmr, Suite 308, Los Angeles, CA 90033-0110 |
| Sue E Martin | Pathology | Usc Care Medical Group Inc | 2011 Zonal Ave Hmr, Suite 308, Los Angeles, CA 90033-0110 |
| Maria E Sibug Saber | Pathology | Usc Care Medical Group Inc | 2011 Zonal Ave Hmr, Suite 308, Los Angeles, CA 90033-0110 |
| Maria Esperanza Vergara-lluri | Pathology | Usc Care Medical Group Inc | 2011 Zonal Ave Hmr, Suite 308, Los Angeles, CA 90033-0110 |
| Gary Craig Kanel | Pathology | Usc Care Medical Group Inc | 2011 Zonal Ave Hmr, Suite 308, Los Angeles, CA 90033-0110 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eric Leung | Internal Medicine | Senior Care Clinic A Medical Corp | 1700 Cesar Chavez Ave, Suite 3900, Los Angeles, CA 90033 |
| Faisal A Khan | General Surgery | Surgical Multispecialties Medical Group | 1701 Cesar Chavez Ave, Suite 300, Los Angeles, CA 90033 |
| Arpita Amin Devani | Internal Medicine | 1720 E Cesar Chavez Ave, Los Angeles, CA 90033 | |
| Azmy F Ghaly | Internal Medicine | Senior Care Clinic A Medical Corp | 1700 Cesar Chavez Ave, Suite 3900, Los Angeles, CA 90033 |
| Marian A Fedak | Internal Medicine | Senior Care Clinic A Medical Corp | 1700 Cesar Chavez Ave, Suite 3900, Los Angeles, CA 90033 |
| Matthew S C Tan | General Surgery | Surgical Multispecialties Medical Group | 1701 Cesar Chavez Ave, Suite 300, Los Angeles, CA 90033 |
| Ramsay Nucho | Thoracic Surgery | Surgical Multispecialties Medical Group | 1701 Cesar Chavez Ave, Suite 300, Los Angeles, CA 90033 |
| Ahmad Jabaiah | Internal Medicine | Senior Care Clinic A Medical Corp | 1700 Cesar Chavez Ave, Suite 3900, Los Angeles, CA 90033 |
| Francisco Quijas | Internal Medicine | Senior Care Clinic A Medical Corp | 1700 Cesar Chavez Ave, Suite 3900, Los Angeles, CA 90033 |
| Rene N Kohlieber | Family Medicine | Senior Care Clinic A Medical Corp | 1700 Cesar Chavez Ave, Suite 3900, Los Angeles, CA 90033 |
| Find all physicians in zip 90033 | |||
| City | LOS ANGELES |
| Zip Code | 90033 |
| Specialty | PATHOLOGY |
| City + Specialty | LOS ANGELES + PATHOLOGY |
Please comment or provide details below to improve the information on William Dean 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.