WALLACE JACK SCHWAM

PISMO BEACH, CA
NPI1902144694
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207RG0300X Internal Medicine, Geriatric Medicine
(Licence: CA  GFE12267)
Enumeration Date2013-01-30
Last Update Date2013-01-30
Business Address
Dr. WALLACE JACK SCHWAM M.D.
210 INDIO DR
PISMO BEACH, CA 93449-1514
Phone number: 805-231-8699
Mailing Address
Dr. WALLACE JACK SCHWAM M.D.
PO BOX 1158
SOLVANG, CA 93464-1158
Phone number: 805-231-8699