MRS. DEBRA ANN WALLACE (NPI# 1770006538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770006538 |
| Entity Type | Individual |
| Full Name | MRS. DEBRA ANN WALLACE |
| Credential | FNP |
| Practice Address |
1100 N State Street Clinic Tower A6a231a Los Angeles CA 90033 |
| Mailing Address |
4632 E Village Rd Long Beach CA 90808-1545 |
| Practice Telephone | 3234097788 |
| Practice Fax Number | 3234417298 |
| Mailing Telephone | 3234097788 |
| Mailing Fax Number | 3234417298 |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2018-06-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
8326 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912149188 | Debra Ann Wallace | Adult Companion | 5608 Kenny Dr, Tampa, FL 33617-7711 | 2009-04-02 |
| 1598005019 | Debra Wallace | Marriage & Family Therapist | 27979 N Converse Rd, Island Lake, IL 60042-8103 | 2013-02-20 |
| 1619271228 | Debra J Wallace | Counselor | 1207 W State St, Suite F, Alliance, OH 44601-4686 | 2010-12-23 |
| 1285877464 | Debra Wallace | Registered Nurse | 50 Redfield St, Suite 302, Dorchester, MA 02122-3630 | 2009-04-17 |
| 1962612168 | Debra Elaine Wallace | Dental Hygienist | 210 Jones Rd, Falmouth, MA 02540-2974 | 2007-05-23 |
| 1164570065 | Debra R Wallace | Nurse Practitioner | 13652 Cantara St, Panorama City, CA 91402-5423 | 2007-01-08 |
| 1174631121 | Debra J Wallace | Social Worker | 171 Ashley Ave, Charleston, SC 29425-0001 | 2006-08-29 |
| 1033186911 | Debra J Wallace | Family Medicine | 1284 Us Highway 60 W, Morganfield, KY 42437-6236 | 2006-03-01 |
| Street Address |
1100 N STATE STREET CLINIC TOWER A6A231A |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790962165 | Usc Care Medical Group, Inc. | Clinic/Center | 1100 N State Street, A1d, Los Angeles, CA 90033 | 2008-01-28 |
| 1083136469 | Jane S. Kim | Registered Nurse | 1100 N State Street, Ct A4a, Los Angeles, CA 90033 | 2017-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376165050 | Noa Yee | Student in an Organized Health Care Education/Training Program | 1200 N. State Street, Gnh 1011, Los Angeles, CA 90033 | 2020-05-15 |
| 1629690144 | Monica Lopez | Respiratory Therapist, Registered | 1251 Marengo St, Los Angeles, CA 90033 | 2020-05-07 |
| 1649890401 | Antonio Hernandez Saenz | Student in an Organized Health Care Education/Training Program | 1200 N. State Street Gnh 1060k, Los Angeles, CA 90033 | 2020-04-22 |
| 1417585100 | Kelsey Grace Shea | Student in an Organized Health Care Education/Training Program | 1200 N State St Ird 112, Los Angeles, CA 90033 | 2020-03-30 |
| 1891322780 | Carolyn Kan | Student in an Organized Health Care Education/Training Program | 1200 North State Street Clinic Tower, Suite A7d, Los Angeles, CA 90033 | 2020-03-23 |
| 1902445786 | Maury M Hopkins | Registered Nurse | 1883 Marengo Street, Los Angeles, CA 90033 | 2019-12-27 |
| 1982259792 | Beverly Austin Mccabe | Registered Nurse | 1720 E. Cesar Chavez Ave., Los Angeles, CA 90033 | 2019-08-08 |
| 1093369399 | Christine Yoon | Pharmacist | 1611 E Cesar Chavez Ave, Los Angeles, CA 90033 | 2019-07-25 |
| 1073075339 | Johanna Keller | Student in an Organized Health Care Education/Training Program | La County +usc Medical Center, 2051 Marengo Street, Los Angeles, CA 90033 | 2019-04-04 |
| 1386115137 | Sonya Lorain Earley | Physician Assistant | 2020 Zonal Avenue, Ird 626, Los Angeles, CA 90033 | 2018-12-05 |
| Find all providers in zip 90033 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447560289 | Tadeusz Wellisz | Surgery | 536 South Rimpau Blvd, Los Angeles, CA 90020 | 2010-10-14 |
| 1801971478 | Kyoung Chol Kim | Surgery | 2970 W Olympic Blvd, Suite 204 & 205, Los Angeles, CA 90006-2518 | 2006-10-25 |
| 1003369380 | Integrative Medical Group, Inc | Surgery | 2200 W 3rd St, Suite 120 A, Los Angeles, CA 90057-1932 | 2016-08-03 |
| 1841659042 | Ryan Spivak Integrative Plastic Surgery Inc | Surgery | 2200 W 3rd St, Suite 120a, Los Angeles, CA 90057-1932 | 2016-02-16 |
| 1548659170 | Libby Wilson Md Inc | Surgery | 403 W Adams Blvd, Los Angeles, CA 90007-2664 | 2015-01-20 |
| 1811330566 | Ginger C Slack | Surgery | 200 Ucla Medical Plz Ste 460, Los Angeles, CA 90095-5224 | 2013-04-12 |
| 1265705925 | Gary Motykie, M.d. A Medical Corporation | Surgery | 9201 W Sunset Blvd, Suite Gf-1, Los Angeles, CA 90069-3701 | 2012-02-10 |
| 1851607642 | Mark L Labowe M D A Prof Corp | Surgery | 12301 Wilshire Blvd, Suite 325, Los Angeles, CA 90025-1007 | 2010-08-31 |
| 1699003731 | Jeffrey D Hoefflin Md Inc | Surgery | 9201 W Sunset Blvd, Ste.#805, Los Angeles, CA 90069-3701 | 2009-12-01 |
| 1255579272 | Anita Patel, M.d., Inc. | Surgery | 1245 Wilshire Blvd, Suite 601, Los Angeles, CA 90017-4810 | 2009-01-29 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90033 |
Please comment or provide details below to improve the information on MRS. DEBRA ANN WALLACE.
| 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.