Alice Wallack, MD

NPI #1316957103 in Pismo Beach, California

Provider Information

NPI Number: 1316957103
Entity Type: Individual
Name: Alice Wallack, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Internal Medicine
Credential: MD
Enumeration Date: Aug 8, 2006
Last Updated: May 9, 2012

Practice Location

Address: 931 OAK PARK BLVD
Address 2: SUITE 101
City: Pismo Beach
State: California
ZIP Code: 93449-3402
Phone: (805) 474-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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