Individual
DAVID G WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
52 DORE ST, SAN FRANCISCO, CA 94103-3828
(415) 861-0828
(415) 861-0140
Mailing address
368 FELL ST, SAN FRANCISCO, CA 94102-5144
(415) 861-0828
(415) 861-0140
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
95230212
AZ
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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