DEBRA ANN WALLACE

LOS ANGELES, CA
NPI1770006538
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy2086S0122X Surgery, Plastic and Reconstructive Surgery
(Licence: CA  8326)
Enumeration Date2017-07-24
Last Update Date2018-06-16
Business Address
Mrs. DEBRA ANN WALLACE FNP
1100 N STATE STREET CLINIC TOWER A6A231A
LOS ANGELES, CA 90033
Phone number: 323-409-7788
Mailing Address
Mrs. DEBRA ANN WALLACE FNP
4632 E VILLAGE RD
LONG BEACH, CA 90808-1545
Phone number: 323-409-7788