WALLACE MEDICAL GROUP, INC
NPI 1104047596
Dermatology - Procedural Dermatology in Beverly Hills, CA

Q: What is Wallace Medical Group, Inc's NPI number?

The NPI number for Wallace Medical Group, Inc is 1104047596. It was assigned to this organization in the NPPES registry on May 1, 2007.

Q: What is Wallace Medical Group, Inc's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Active since May 01, 2007

8920 WILSHIRE BLVD, SUITE 327, BEVERLY HILLS, CA 90211(310) 652-8460 Get Directions Write a Review

NPPES record last updated: October 16, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Wallace Medical Group, Inc NPPES

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

WALLACE MEDICAL GROUP, INC (NPI 1104047596) is a healthcare organization registered as a procedural dermatology in Beverly Hills, California and active in the NPI registry since May 2007. The organization lists Paul Wesley Wallace, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1104047596

Entity TypeOrganization

Primary Taxonomy207NS0135X

Legal Business NameWALLACE MEDICAL GROUP, INC

Location Address8920 WILSHIRE BLVD, SUITE 327Beverly Hills, CA 90211-2007

Mailing Address8920 Wilshire Blvd, Suite 327Beverly Hills, CA 90211-2007 · (310) 652-8460

Phone(310) 652-8460

Organization SubpartNo

Authorized OfficialPaul Wesley WallaceMedical Director · (310) 652-8460

Enumeration DateMay 1, 2007

Last NPPES UpdateOctober 16, 2007

✔ NPI 1104047596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207NS0135X

License✔ Licensed in CA · A49918

Definition

Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

8920 WILSHIRE BLVD, Beverly Hills, CA 90211

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Other Identifiers 3

Medicare ID-Type UnspecifiedW16377

MedicaidGR0062020CA

Medicare UPINF46168

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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.

DR. STEVE CHEN M.D.

Surgery (Pediatric Surgery)

8920 WILSHIRE BLVD, SUITE 326
BEVERLY HILLS, CA 90211

Los Angeles County (310) 598-7738

MR. A KEVIN AMINIAN MD

Psychiatry & Neurology (Neurology)

8920 WILSHIRE BLVD, SUITE 548
BEVERLY HILLS, CA 90211

Los Angeles County (310) 358-0700

DR. PAUL WESLEY WALLACE MD

Dermatology

8920 WILSHIRE BLVD, SUITE 327
BEVERLY HILLS, CA 90211

Los Angeles County (310) 652-8460

DR. MARY MIGLIETTA-ROTHMAN DDS

Dentist

8920 WILSHIRE BLVD, SU. 410
BEVERLY HILLS, CA 90211

Los Angeles County (310) 652-2360

DR. GLENN A MARSHAK M.D.

Internal Medicine

8920 WILSHIRE BLVD
BEVERLY HILLS, CA 90211

Los Angeles County (310) 553-5203

JOHN D ROMM MD A MEDICAL CORPORATION

Internal Medicine (Gastroenterology)

8920 WILSHIRE BLVD, STE #330
BEVERLY HILLS, CA 90211

Los Angeles County (310) 854-5638

DR. MICHELE L FRAWLEY DDS

Dentist (General Practice)

8920 WILSHIRE BLVD, SUITE 701
BEVERLY HILLS, CA 90211

Los Angeles County (310) 652-8383

TOM FLASHMAN MEDICAL CORPORATION

Specialist

8920 WILSHIRE BLVD, SUITE 301
BEVERLY HILLS, CA 90211

Los Angeles County (310) 360-9245

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 Medical Group, Inc's NPI number?

The NPI number for Wallace Medical Group, Inc is 1104047596. It was assigned to this organization in the NPPES registry on May 1, 2007.

Where is Wallace Medical Group, Inc located?

Wallace Medical Group, Inc is located at 8920 Wilshire Blvd Suite 327, Beverly Hills, CA 90211. The listed phone number is (310) 652-8460.

What is Wallace Medical Group, Inc's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

When was this NPI record last updated?

The NPPES record for Wallace Medical Group, Inc was last updated on October 16, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.