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Robert Wallace
NPI 1427460518 · on the registry since 2014
Practice
- Address
- 2060 Campus Dr
Yreka, CA 96097 - Phone
- (530) 841-4824
- Organisation at this address
- County Of Siskiyou
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 164
Registry record
- Primary taxonomy
- 171M00000X
171M00000X
- Licence states on file
- NULL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2014-05-23
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