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DR. CHARLES DOUGLAS WALLACE M.D.
NPI 1144229600
Orthopaedic Surgery in San Diego, CA

Active since July 18, 2005PECOS EnrolledAccepts Medicare Assignment
3030 CHILDRENS WAY, STE 410, SAN DIEGO, CA 92123(858) 966-6789(858) 966-8519 Get Directions Write a Review

NPPES record last updated: November 2, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Charles Douglas Wallace M.d. NPPES

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

DR. CHARLES DOUGLAS WALLACE M.D. (NPI 1144229600) is an individual orthopaedic surgery provider in San Diego, California, licensed in California (G67953) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Michigan Medical School (1988).

NPPES Registry Identity

NPI1144229600
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. CHARLES DOUGLAS WALLACECredential: M.D.
Location Address3030 CHILDRENS WAY, STE 410San Diego, CA 92123-4232
Mailing Address3860 Calle Fortunada, Ste #210San Diego, CA 92123-4802 · (858) 309-6303 · Fax (858) 309-6301
Phone(858) 966-6789
Fax(858) 966-8519
Sole ProprietorNo
Medical School CMSUniversity Of Michigan Medical SchoolGraduated 1988
Enumeration DateJuly 18, 2005
Last NPPES UpdateNovember 2, 2011
✔ NPI 1144229600 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in CA · G67953
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
3030 CHILDRENS WAY, San Diego, CA 92123
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Charles Douglas Wallace M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2769548775
PECOS Enrollment IDI20090226000607
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92123 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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. STEPHANIE LEONARD MEASURES MD
Allergy & Immunology
3030 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-5961
DR. STEVEN ALEXANDER BUREKHOVICH MD
Orthopaedic Surgery
3030 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-6789
ERIC WILLIAM EDMONDS MD
Orthopaedic Surgery
3030 CHILDRENS WAY, SUITE 410
SAN DIEGO, CA 92123
San Diego County (858) 966-6789
CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF OPTH
Ophthalmology
3030 CHILDRENS WAY, SUITE 109
SAN DIEGO, CA 92123
San Diego County (858) 309-7701
ANGELA LEE CHU M.D.
Pediatrics (Pediatric Gastroenterology)
3030 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-4003
HERBERT CLIFFORD KIMMONS JR. M.D.
Pediatrics
3030 CHILDRENS WAY, SUITE 213
SAN DIEGO, CA 92123
San Diego County (858) 966-8567
PETER OWEN NEWTON M.D.
Orthopaedic Surgery
3030 CHILDRENS WAY, SUITE 410
SAN DIEGO, CA 92123
San Diego County (858) 966-6789
MARYLOU SCOTT CPNP
Nurse Practitioner (Pediatrics)
3030 CHILDRENS WAY, STE 410
SAN DIEGO, CA 92123
San Diego County (858) 966-6789

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 Charles Wallace's NPI number?

The NPI number for Charles Wallace is 1144229600. It was assigned to this individual provider in the NPPES registry on July 18, 2005.

Where is Charles Wallace located?

Charles Wallace practices at 3030 Childrens Way Ste 410, San Diego, CA 92123. The listed phone number is (858) 966-6789.

What is Charles Wallace's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Charles Wallace enrolled in Medicare?

Yes. Charles Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Charles Wallace was last updated on November 2, 2011. 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.