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1578502191
ERIC WALLACE
VENTURA, CA
NPI
1578502191
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: CA A85195)
Enumeration Date
2006-06-06
Last Update Date
2017-11-14
Business Address
-- ERIC WALLACE MD
168 N BRENT ST SUITE 402
VENTURA, CA 93003-2817
Phone number: 888-234-0004
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Mailing Address
-- ERIC WALLACE MD
4100 GUARDIAN ST STE 205
SIMI VALLEY, CA 93063-6721
Phone number: 855-504-4544
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