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1144304353
MICHAEL J. WALLACE
SANTA MONICA, CA
NPI
1144304353
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207L00000X Anesthesiology
(Licence: CA C41232)
Enumeration Date
2006-10-24
Last Update Date
2007-07-08
Business Address
Dr. MICHAEL J. WALLACE M.D.
1328 22ND ST
SANTA MONICA, CA 90404-2032
Phone number: 310-471-5852
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Mailing Address
Dr. MICHAEL J. WALLACE M.D.
11999 SAN VICENTE BLVD #440
LOS ANGELES, CA 90049-5131
Phone number: 310-471-5852
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