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WALLACE B CARROLL MD
NPI 1003874124
Allergy & Immunology - Allergy in Modesto, CA

Active since May 01, 2006
600 COFFEE RD, MODESTO, CA 95355(209) 524-1211 Get Directions Write a Review

NPPES record last updated: May 28, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wallace B Carroll Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALLACE B CARROLL MD (NPI 1003874124) is an individual allergy provider in Modesto, California, licensed in California (A31444) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1003874124
Entity TypeIndividualMale
Primary Taxonomy207KA0200X
Provider Legal NameWALLACE B CARROLLCredential: MD
Location Address600 COFFEE RDModesto, CA 95355-4201
Mailing Address600 Coffee RdModesto, CA 95355-4201 · (209) 524-1211
Phone(209) 524-1211
Sole ProprietorNo
Enumeration DateMay 1, 2006
Last NPPES UpdateMay 28, 2010
✔ NPI 1003874124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAllergy & Immunology · AllergyAllopathic & Osteopathic Physicians
Taxonomy Code207KA0200X
License✔ Licensed in CA · A31444
Definition
A physician who specializes in the diagnosis, treatment, and management of allergies. Source: National Uniform Claim Committee
Also ListedPediatricsTaxonomy 208000000X · License A31444 (CA)
600 COFFEE RD, Modesto, CA 95355
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Other Identifiers 3

Medicare PIN00A314441CA
Medicare UPINA26484CA
Medicaid00A314440CA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RADHA CHIRUMAMILLA M.D.
Hospitalist
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 524-1211
CYRUS M RABII MD
Emergency Medicine
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 521-6097
RONALD D. JENSEN DPM
Podiatrist
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 524-1211
PALLAVI SHARMA MD
Family Medicine
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 521-6097
SWE THAN M.D.,PH.D
Internal Medicine
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 550-4702
VIVIAN L TAN M.D.
Anesthesiology
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 524-1211
KENNETH IMANAKA MD
Anesthesiology
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 524-1211
DAVID ALLEN BETZ MD
Anesthesiology
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 524-1211

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wallace Carroll's NPI number?

The NPI number for Wallace Carroll is 1003874124. It was assigned to this individual provider in the NPPES registry on May 1, 2006.

Where is Wallace Carroll located?

Wallace Carroll practices at 600 Coffee Rd, Modesto, CA 95355. The listed phone number is (209) 524-1211.

What is Wallace Carroll's specialty?

The primary specialty registered for this NPI is Allergy & Immunology, specializing in Allergy, with taxonomy code 207KA0200X.

When was this NPI record last updated?

The NPPES record for Wallace Carroll was last updated on May 28, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.