Paul Wesley Wallace MD

NPI 1063494474 - Dermatology - 207N00000X

NPI Details
NPI 1063494474
Gender Male
Enumeration Date 11/19/2005
Last Updated 10/16/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
8920 WILSHIRE BLVD
SUITE 327
BEVERLY HILLS CA, 90211-2007, US
Phone (310) 652-8460
Fax (310) 652-8499
Business Location
8920 WILSHIRE BLVD
SUITE 327
BEVERLY HILLS CA, 90211-2007, US
Phone (310) 652-8460
Fax (310) 652-8499
Toxanomy
Taxonomy Code 207N00000X
License State California
License Number A049918
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According to our database, Dr. Paul Wesley Wallace MD NPI is 1063494474, taxonomy code is 207N00000X and license number is A049918, license state is located at California. Paul Wesley Wallace MD physically located at 8920 Wilshire Blvd, Beverly Hills CA, 90211-2007. NPI Number Paul Wesley Wallace MD has the Individual type.

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1063494474 NPI number is provided on an as is basis without warranty of any kind. 1063494474 is maintained by the National Plan & Provider Enumeration System. The contents of Paul Wesley Wallace MD are for informational purposes only.