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Organization
PATRICIA A. WALLACE, M.D., INC.
Active
Organization
PATRICIA A. WALLACE, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA ANN WALLACE MD (PRESIDENT)
(949) 364-4400
Entity
Organization
Contact information
Practice address
26732 CROWN VALLEY PKWY, SUITE 327, MISSION VIEJO, CA 92691-6306
(949) 364-4400
(949) 364-2829
Mailing address
26732 CROWN VALLEY PKWY, SUITE 327, MISSION VIEJO, CA 92691-6306
(949) 364-4400
(949) 364-2829
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A73003
CA
Other
Enumeration date
05/16/2008
Last updated
05/16/2008
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