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1679641666
THOMAS M WALLACE
MODESTO, CA
NPI
1679641666
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RC0200X Internal Medicine, Critical Care Medicine
(Licence: CA G42269)
Enumeration Date
2006-11-30
Last Update Date
2007-07-08
Business Address
-- THOMAS M WALLACE M.D.
1441 FLORIDA AVE
MODESTO, CA 95350-4405
Phone number: 209-576-3525
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Mailing Address
-- THOMAS M WALLACE M.D.
1441 FLORIDA AVE
MODESTO, CA 95350-4405
Phone number: 209-576-3525
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