Search › California › 111N00000X
Timothy Wallace, D.C
NPI 1063438307 · on the registry since 2006 · sole proprietor
Practice
- Address
- 4357 Phelan Rd
Phelan, CA 92371 - Phone
- (760) 868-4481
- Fax
- (760) 868-1879
Registry record
- Primary taxonomy
- 111N00000X
111N00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-01-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California