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1316426679
BRANDON M WALLACE
LOS ANGELES, CA
NPI
1316426679
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
213ES0103X Podiatrist, Foot & Ankle Surgery
(Licence: CA E5705)
Enumeration Date
2018-08-08
Last Update Date
2020-08-27
Business Address
Dr. BRANDON M WALLACE DPM
1701 E CESAR E CHAVEZ AVE STE 510
LOS ANGELES, CA 90033-2488
Phone number: 323-269-5205
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Mailing Address
Dr. BRANDON M WALLACE DPM
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA 90033-2414
Phone number:
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