DR. Grant Charles Wallace, M.D.
NPI #1043208101 in Oceanside, California
Provider Information
- NPI Number
- 1043208101
- Entity Type
- Individual
- Name
- DR. Grant Charles Wallace, M.D.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Radiology - Diagnostic Radiology
- Credential
- M.D.
- Enumeration Date
- Oct 12, 2005
- Last Updated
- Sep 25, 2023
Practice Location
- Address
- 200 MERCY CIRCLE
- City
- Oceanside
- State
- California
- ZIP Code
- 92055
- Phone
- (760) 719-3479
Specialties & Taxonomy Codes
| Specialty |
|---|
| Radiology - Diagnostic Radiology — Diagnostic Radiology |
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