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1689791139
MICHAEL S. WALLACK
SAN FERNANDO, CA
NPI
1689791139
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: CA G12118)
Enumeration Date
2007-03-22
Last Update Date
2007-07-08
Business Address
-- MICHAEL S. WALLACK M.D.
1600 SAN FERNANDO ROAD
SAN FERNANDO, CA 91340
Phone number: 818-365-8086
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Mailing Address
-- MICHAEL S. WALLACK M.D.
4801 BRANDENBURG
TARZANA, CA 91350
Phone number: 818-342-4440
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