John George Wallace JR.
Emergency Medical Services
4101 Torrance Blvd Em Dept
Torrance
, California 90503-4607
John George Wallace JR.
Emergency Medical Services
4101 Torrance Blvd Em Dept
Torrance
, California 90503-4607
(405) 751-3183
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About
Features
Specialties
- Emergency Medical Services
Languages spoken
- English
Location
First Address
- John George Wallace JR.
- 4401 W Memorial Rd Suite 121
- Oklahoma City, OK
- Zip : 73134-1785
- Fax : (405) 751-3183
- Phone : (405) 751-4664
Second Address
- John George Wallace JR.
- 4101 Torrance Blvd Em Dept
- Torrance, CA
- Zip : 90503-4607
- Fax : (405) 751-3183
- Phone : (310) 540-7676
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207PE0004X | Emergency Medical Services | G45690 | CA |
National Provider Identifier
| NPI | 1164467320 |
|---|---|
| Provider Name | John George Wallace JR. |
| First Address | Oklahoma City, OK 73134-1785 |
| Second Address | Torrance, CA 90503-4607 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/06/2006 |
| Last Update Date | 19/09/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00G456900 | (05) | CA |
| A50147 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.