MATTHEW EVAN WALLACE

SAN DIEGO, CA
NPI1881177806
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: CA  NP95010225)
Enumeration Date2018-09-14
Last Update Date2018-12-10
Business Address
Mr. MATTHEW EVAN WALLACE NP
200 W ARBOR DR
SAN DIEGO, CA 92103-9000
Phone number: 619-306-5855
Mailing Address
Mr. MATTHEW EVAN WALLACE NP
PO BOX 232410
SAN DIEGO, CA 92193-2410
Phone number:
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