DAVID WALLACE


Address: 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459
Phone: 2422693400

DAVID WALLACE (NPI# 1174015499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1174015499
Entity Type Individual
Full Name DAVID WALLACE
Credential BS-SLPA
Practice Address 11840 S La Cienega Blvd
Hawthorne
CA 90250-3459
Practice Telephone 2422693400
Practice Fax Number 3108825451
Mailing Telephone 2422693400
Mailing Fax Number 3108825451
Enumeration Date 2018-06-01
Last Update Date 2020-02-25
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2355S0801X Specialist/Technologist
Specialization: Speech-Language Assistant
3499 CA Speech, Language and Hearing Service Providers
N 235Z00000X Speech-Language Pathologist 3499 CA Speech, Language and Hearing Service Providers

Other Providers DAVID WALLACE

NPI Name Taxonomy Address Enumeration
1700327061 David Wallace Student in an Organized Health Care Education/Training Program 24606 Mosquero Ln, Mission Viejo, CA 92691-4913 2017-03-19
1265743595 David R Wallace Jr. Radiology 200 W Arbor Dr # Mc0834, Department of Radiology, San Diego, CA 92102-0834 2010-07-01
1386868487 David Stuart Wallace Chiropractor 2330 Highway 94 South Outer Rd, Saint Charles, MO 63303-8301 2007-04-12
1649343641 David Michael Wallace Chiropractor 112 W Grand Ave, Rainbow City, AL 35906-3233 2006-11-16
1932193604 David Wallace Anesthesiology 738 Golden Pheasant Dr, Draper, UT 84020-8454 2005-09-08
1386646206 David Allen Wallace Dentist 206 S Walker St, Princeton, WV 24740-2747 2005-08-11
1295736809 David B. Wallace Radiology 325 N Highland Ave, Provena Mercy Medical Center, Aurora, IL 60506-3811 2005-08-04
1679576276 David Alan Wallace Ophthalmology 11600 Wilshire Blvd, Ste 200, Los Angeles, CA 90025-1782 2005-05-27
1619596335 David Alexander Wallace Student in an Organized Health Care Education/Training Program 920 Madison Ave Ste 447, Memphis, TN 38103-3438 2020-04-13
1396364402 David Carter Wallace Student in an Organized Health Care Education/Training Program 620 Shadow Ln, Las Vegas, NV 89106-4119 2020-04-09

Office Location

Street Address 11840 S LA CIENEGA BLVD
City HAWTHORNE
State CA
Zip Code 90250-3459

Providers in the same location

NPI Name Taxonomy Address Enumeration
1578719472 Lisa D Murphy Occupational Therapist 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 2008-08-11
1205444874 Shuyi Wang Physical Therapist 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 2020-07-20
1619593720 Sarah Elena Falcy Occupational Therapist 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 2020-06-24
1578186375 Jordyn Pursel Occupational Therapist 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 2020-05-27
1003458936 Caitlin Rose Parr Physical Therapist 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 2019-10-11
1932761269 Alexis Mei-li Smith Speech-Language Pathologist 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 2019-07-08
1356906010 Kristen Ann Maranan Physical Therapist 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 2019-05-07
1366907537 Napa Center, Inc Occupational Therapist 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 2019-02-01
1629533898 Napa Center, Inc Speech-Language Pathologist 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 2019-02-01
1811452089 Napa Center, Inc Physical Therapist 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 2019-02-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1508479627 Alexis Lemmon Dental Hygienist 13450 Hawthrone Blvd, Hawthorne, CA 90250 2020-08-28
1336620459 Lan Ngoc Ton Dentist 13450 S. Hawthorne Blvd, Hawthorne, CA 90250 2018-08-27
1356829261 Karneth Health Inc Internal Medicine 4512 W. Imperial Hwy, Ste B, Hawthorne, CA 90250 2018-08-02
1225524663 Viridian Healthcare LLC In Home Supportive Care 13658 Hawthorne Blvd Ste 201, Hawthorne, CA 90250 2018-07-09
1235636044 Sonia Medical Center Inc Clinic/Center 4512 W Imperial Hwy, Hawthorne, CA 90250 2018-04-09
1518484807 Jessica Anne-marie Auzenne-harris Nurse Practitioner 12618 Hawthorne Blvd, Hawthorne, CA 90250 2017-08-28
1669993358 Ololade Olamide Obafemi Nurse Practitioner 12954 Hawthorne Boulevard, Suite 104, Hawthorne Morningside Medical Clinic, Hawthorne, CA 90250 2017-07-03
1588194534 Marissam Medical Inc. Durable Medical Equipment & Medical Supplies 13508 Inglewood Ave, Hawthorne, CA 90250 2017-06-13
1043751886 Ogbonna Iwuamadi Olelewe Nurse Practitioner 11712 S. Hawthorne Blvd, Hawthorne, CA 90250 2017-03-13
1952758898 La Shada Kai Martin Contractor 13010 Kornblum Ave, Unit D, Hawthorne, CA 90250 2016-05-20
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Taxonomy Information

Taxonomy Code 2355S0801X
Grouping Speech, Language and Hearing Service Providers
Classification Specialist/Technologist
Specialization Speech-Language Assistant

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1245611243 Amanda Reyes Specialist/Technologist 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 2015-06-16
1295122992 Jamie Marie Lacroix Specialist/Technologist 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 2015-04-20
1275929028 Annais Vazquez Specialist/Technologist 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 2015-04-08
1801290705 Andrea Rutz Specialist/Technologist 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 2014-10-21

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1205434552 Onneka Taitano Specialist/Technologist 18743 Pioneer Blvd Ste 203, Artesia, CA 90701-5662 2020-10-09
1366058505 Amanda Lauren Ramos Liberto Mcnamara Specialist/Technologist 7525 Metropolitan Drive, 308, San Diego, CA 92108-4412 2020-09-22
1851907679 Samantha Gutierrez-curran Specialist/Technologist 12582 Naples Way, Rancho Cucamonga, CA 91739-2631 2020-09-17
1912513904 Jenifer G Camargo Specialist/Technologist 11284 Mountain Ave, Riverside, CA 92505-2633 2020-09-16
1508471186 Rachael Catherine Stankey Specialist/Technologist 7 Seton Ct, Rancho Mirage, CA 92270-3714 2020-09-10
1104431774 Andrea Marie Gonzalez Specialist/Technologist 1202 Kingsdale Dr, Corona, CA 92878-7708 2020-09-10
1316551302 Taylor Kami Hirata Specialist/Technologist 21515 Hawthorne Blvd Ste Gl-100, Torrance, CA 90503-6501 2020-09-07
1811501166 Carla Rita Rambo Specialist/Technologist 14772 Pineline Ave, Chino Hills, CA 91709 2020-09-03
1205449576 Blind Children's Learning Center Specialist/Technologist 18542 Vanderlip Ave, Santa Ana, CA 92705-8201 2020-08-26
1922618867 Jennifer Chan Specialist/Technologist 1281 Calle Cecilia, San Dimas, CA 91773-4435 2020-08-05
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Competitor

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City HAWTHORNE
Zip Code 90250

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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