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Organization
JAMES I. WALLSTROM, M.D., INC.
Active
Organization
JAMES I. WALLSTROM, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES I WALLSTROM M.D. (PRESIDENT)
(626) 792-4115
Entity
Organization
Contact information
Practice address
50 BELLEFONTAINE ST STE 205, PASADENA, CA 91105-3132
(626) 792-4115
(626) 792-3103
Mailing address
50 BELLEFONTAINE ST STE 205, PASADENA, CA 91105-3132
(626) 792-4115
(626) 792-3103
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G74317
CA
Other
Enumeration date
06/15/2011
Last updated
05/16/2012
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