Individual
DR. NICOLAI LYNGE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(619) 543-6268
Mailing address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(858) 657-7000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A194552
CA
208M00000X
Hospitalist Physician
Primary
A194552
CA
Other
Enumeration date
03/24/2021
Last updated
07/30/2024
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