DR. THOMAS CLYDE WALLACE (NPI# 1801942933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801942933 |
| Entity Type | Individual |
| Full Name | DR. THOMAS CLYDE WALLACE |
| Credential | M.D. |
| Practice Address |
10 Congress St Suite 360 Pasadena CA 91105-3023 |
| Practice Telephone | 6264321640 |
| Practice Fax Number | 6267936381 |
| Mailing Telephone | 6264321640 |
| Mailing Fax Number | 6267936381 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
A-43490 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DEA NUMBER | BW-0891552 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124021696 | Thomas R Wallace | Ophthalmology | 211 Mcauley Ct, Hot Springs, AR 71913-6314 | 2005-05-27 |
| 1316547342 | Thomas E Wallace IIi | Pharmacist | 1571 Forest Ave, Staten Island, NY 10302-2226 | 2020-10-28 |
| 1023499217 | Thomas Wallace | Massage Therapist | 17205 Vashon Hwy Sw, Suite B2, Vashon, WA 98070-4674 | 2015-06-12 |
| 1275945354 | Thomas Wallace Jr. | Counselor | 1646 S Court St, Visalia, CA 93277-4962 | 2014-05-23 |
| 1265787147 | Thomas Danville Wallace | Pharmacy Technician | 215 Dexter L Woods Memorial Blvd, Waynesboro, TN 38485-2416 | 2012-07-17 |
| 1386789147 | Thomas W Wallace | Psychiatry & Neurology | 180 Grand Ave Ste 100, Oakland, CA 94612-3766 | 2007-02-20 |
| 1679641666 | Thomas M Wallace | Internal Medicine | 1441 Florida Ave, Modesto, CA 95350-4405 | 2006-11-30 |
| 1295807733 | Thomas Witherspoon Wallace | Internal Medicine | 10100 Kanis Rd, Little Rock, AR 72205-6202 | 2006-11-13 |
| 1639251416 | Thomas A Wallace | Social Worker | 254 N Washington St, Falls Church, VA 22046-4517 | 2006-10-20 |
| 1811089006 | Thomas K Wallace | Nurse Anesthetist, Certified Registered | 800 E 28th St, Minneapolis, MN 55407-3723 | 2006-09-28 |
| Street Address |
10 CONGRESS ST SUITE 360 |
| City | PASADENA |
| State | CA |
| Zip Code | 91105-3023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861495483 | Kathy Nguyen Walker | Obstetrics & Gynecology | 10 Congress St, Ste 202, Pasadena, CA 91105-3027 | 2005-05-27 |
| 1982114625 | Malinda Miller | Nurse Practitioner | 10 Congress St, Pasadena, CA 91105-3045 | 2017-10-09 |
| 1821449190 | Huntington Perinatal Group Inc | Obstetrics & Gynecology | 10 Congress St, Suite 511, Pasadena, CA 91105-3045 | 2016-06-28 |
| 1659749182 | Transam Hua | Physical Therapist | 10 Congress St, Suite 103, Pasadena, CA 91105-3027 | 2015-09-15 |
| 1356718530 | Huntington Orthopedics Surgical Medical Group | Clinic/Center | 10 Congress St, Suite 103, Pasadena, CA 91105-3027 | 2015-08-24 |
| 1437543501 | Wufaa Alrashid M.d., Inc | Internal Medicine | 10 Congress St, Suite 512, Pasadena, CA 91105-3045 | 2015-03-26 |
| 1114311560 | Lisa Marie Nakatani | Nurse Practitioner | 10 Congress St, Suite 405, Pasadena, CA 91105-3045 | 2015-03-24 |
| 1093121410 | Advanced Trauma Associates LLC | Surgery | 10 Congress St, Suite103, Pasadena, CA 91105-3045 | 2014-07-07 |
| 1912318676 | Vanessa Cabe | Internal Medicine | 10 Congress St, Suite 208, Pasadena, CA 91105-3045 | 2014-05-15 |
| 1245669068 | California Fertility Centers, A Medical Corporation | Clinic/Center | 10 Congress St, Suite 200, Pasadena, CA 91105-3045 | 2013-11-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619451697 | Tonya Michlin | Registered Nurse | 800 Fairmount Ave Ste 110, Pasadena, CA 91105 | 2018-09-17 |
| 1639674161 | David Marcus Md, Inc. | Psychiatry & Neurology | 107 S. Fair Oaks Avenue, Suite #315, Pasadena, CA 91105 | 2018-03-27 |
| 1548778541 | Elias & Jun Dental Corp | Dentist | 301 S. Fair Oaks Ave., Ste 107, Pasadena, CA 91105 | 2018-01-12 |
| 1013429745 | Whitney Catalano | Dietitian, Registered | 100 S Orange Grove Blvd, 103, Pasadena, CA 91105 | 2017-11-03 |
| 1518485630 | Marlon O Miller | Counselor | 1020 South Arroyo Parkway, Pasadena, CA 91105 | 2017-09-08 |
| 1316469976 | Alexandra Scott | Speech-Language Pathologist | 235 La Vereda Road, Pasadena, CA 91105 | 2017-07-14 |
| 1346770443 | Amanda Grace Gentz | Rehabilitation Practitioner | 210 S De Lacey, Ste 110, Pasadena, CA 91105 | 2017-06-13 |
| 1427598390 | Melina Gomez Loza | Licensed Vocational Nurse | 66 Hilburt St #2, Pasadena, CA 91105 | 2017-02-27 |
| 1588115281 | Ramon Banuelos | Rehabilitation Practitioner | 210 S. Delacey Ave Suite 110, Pasadena, CA 91105 | 2016-10-18 |
| 1922554245 | Daniel Joseph Ybarra | Student in an Organized Health Care Education/Training Program | 100 W. California Blvd. Pasadena, Ca 91105, Pasadena, CA 91105 | 2016-08-28 |
| Find all providers in zip 91105 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639674161 | David Marcus Md, Inc. | Psychiatry & Neurology | 107 S. Fair Oaks Avenue, Suite #315, Pasadena, CA 91105 | 2018-03-27 |
| 1972015022 | Oasis Mind and Body | Psychiatry & Neurology | 3301 Plainview, 1, Pasadena, TX 77504 | 2017-10-30 |
| 1023401122 | Ara Gregory Barkev Darakjian | Psychiatry & Neurology | 236 W Mountain St # 109-e, Pasadena, CA 91103 | 2015-03-12 |
| 1104261270 | Kristina Eipl | Psychiatry & Neurology | 69 N Catalina Ave, Pasadena, CA 91106 | 2013-05-02 |
| 1154663177 | Howard I Wilson | Psychiatry & Neurology | 2935 Larmona Dr, Pasadena, CA 91107-1125 | 2013-03-18 |
| 1669743464 | John D. F. Tarr M.d., Ph.d., Inc | Psychiatry & Neurology | 280 South Arroyo Boulevard, Pasadena, CA 91105-1507 | 2012-01-25 |
| 1053688689 | Michael Carl Storrie-lombardi | Psychiatry & Neurology | 798 N Mar Vista Ave, Pasadena, CA 91104-4617 | 2011-11-28 |
| 1770714735 | Warren R Procci | Psychiatry & Neurology | 230 S San Rafael Ave, Pasadena, CA 91105-1525 | 2009-08-06 |
| 1598960130 | Foos Psychiatric Medical Group Inc | Psychiatry & Neurology | 2810 East Del Mar Blvd, Suite 11b, Pasadena, CA 91107 | 2007-06-15 |
| 1194842625 | Rogelio Leonardo Whyte | Psychiatry & Neurology | 595 East Colorado Blvd, Suite 507, Pasadena, CA 91101-2039 | 2007-03-22 |
| Find all providers in PASADENA | ||||
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| 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.