Christopher A Wallace, IDC
NPI #1003101775 in San Diego, California
Provider Information
- NPI Number
- 1003101775
- Entity Type
- Individual
- Name
- Christopher A Wallace, IDC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Military Health Care Provider - Independent Duty Corpsman
- Credential
- IDC
- Enumeration Date
- Jun 10, 2011
- Last Updated
- Jun 10, 2011
Practice Location
- Address
- 34101 FARENHOLT AVE
- City
- San Diego
- State
- California
- ZIP Code
- 92134-5000
- Phone
- (619) 532-7801
Specialties & Taxonomy Codes
| Specialty |
|---|
| Military Health Care Provider - Independent Duty Corpsman — Independent Duty Corpsman |
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