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Individual

BARRY JAY WALLMAN

Active
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Individual

BARRY JAY WALLMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G58527
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952318461
NPI NUMBER INDIVIDUAL
CA
01
—
CB227753
PTAN
CA
Enumeration date
08/01/2006
Last updated
04/22/2015
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