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Individual
WALLACE BLAKE MCKINNEY
Active
Individual
WALLACE BLAKE MCKINNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A105593
CA
Other
Enumeration date
05/08/2008
Last updated
09/24/2008
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