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DR. TIMOTHY MARK WALLACE D.C.
NPI 1063438307
Chiropractor in Phelan, CA

Active since July 13, 2006
4357 PHELAN RD, PHELAN, CA 92371(760) 868-4481(760) 868-1879 Get Directions Write a Review

NPPES record last updated: January 27, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Timothy Mark Wallace D.c. NPPES

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

DR. TIMOTHY MARK WALLACE D.C. (NPI 1063438307) is an individual chiropractor in Phelan, California, licensed in California (23400) and active in the NPI registry since July 2006. He is a graduate of Los Angeles College Of Chiropractic (1999).

NPPES Registry Identity

NPI1063438307
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameDR. TIMOTHY MARK WALLACECredential: D.C.
Location Address4357 PHELAN RDPhelan, CA 92371-7675
Mailing Address4357 Phelan RdPhelan, CA 92371-7675 · (760) 868-4481 · Fax (760) 868-1879
Phone(760) 868-4481
Fax(760) 868-1879
Sole ProprietorYes
Medical School CMSLos Angeles College Of ChiropracticGraduated 1999
Enumeration DateJuly 13, 2006
Last NPPES UpdateJanuary 27, 2012
✔ NPI 1063438307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in CA · 23400
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
4357 PHELAN RD, Phelan, CA 92371
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Other Identifiers 2

Medicare UPINU52228CA
Medicare ID-Type UnspecifiedDC0234000CA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Timothy Mark Wallace D.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8628238573
PECOS Enrollment IDI20120329000730

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chiropractic manipulative treatment, 3-4 spinal regions 98941
Chiropractic manipulative treatment for 3-4 spinal regions involves a trained professional applying controlled force to specific areas of your spine. This can help alleviate pain, improve physical function, and support your body's natural healing process.
205 services24 patients

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 Timothy Wallace's NPI number?

The NPI number for Timothy Wallace is 1063438307. It was assigned to this individual provider in the NPPES registry on July 13, 2006.

Where is Timothy Wallace located?

Timothy Wallace practices at 4357 Phelan Rd, Phelan, CA 92371. The listed phone number is (760) 868-4481.

What is Timothy Wallace's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Timothy Wallace enrolled in Medicare?

Yes. Timothy Wallace is registered in the Medicare PECOS enrollment system.

What insurance does Timothy Wallace accept?

Health plans from Providence Health Plan list Timothy Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Timothy Wallace was last updated on January 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.