Individual
PATRICIA A WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
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
A73003
CA
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
A73003
CA
Other
Enumeration date
10/03/2006
Last updated
08/19/2014
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