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1154422343
WALLACE MEDICAL GROUP
BEVERLY HILLS, CA
NPI
1154422343
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Entity Type
Organization
Authorized Contact
PAUL WESLEY WALLACE
President
310-652-8460
Organization Subpart ?
No
Primary Taxonomy
207N00000X Dermatology
(Licence: CA A49918)
Enumeration Date
2006-09-26
Last Update Date
2007-10-11
Business Address
WALLACE MEDICAL GROUP
8920 WILSHIRE BLVD #327
BEVERLY HILLS, CA 90211-2007
Phone number: 310-652-8460
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Mailing Address
WALLACE MEDICAL GROUP
8920 WILSHIRE BLVD #327
BEVERLY HILLS, CA 90211-2003
Phone number: 310-652-8460
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