DR. WILLIAM W WALLACE M.D.
NPI 1144331513
Allergy & Immunology - Allergy in San Diego, CA

Q: What is William Wallace's NPI number?

The NPI number for William Wallace is 1144331513. It was assigned to this individual provider in the NPPES registry on August 31, 2006.

Q: What is William Wallace's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for William Wallace was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since August 31, 2006PECOS Enrolled

8933 ACTIVITY RD, SAN DIEGO, CA 92126(858) 653-6170 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. William W Wallace M.d. NPPES

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

DR. WILLIAM W WALLACE M.D. (NPI 1144331513) is an individual allergy provider in San Diego, California, licensed in California (G17502) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1144331513

Entity TypeIndividualMale

Primary Taxonomy207KA0200X

Provider Legal NameDR. WILLIAM W WALLACECredential: M.D.

Location Address8933 ACTIVITY RDSan Diego, CA 92126-4427

Mailing Address8933 Activity RdSan Diego, CA 92126-4427 · (858) 653-6170

Phone(858) 653-6170

Sole ProprietorNo

Enumeration DateAugust 31, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1144331513 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAllergy & Immunology · AllergyAllopathic & Osteopathic Physicians

Taxonomy Code207KA0200X

License✔ Licensed in CA · G17502

Definition

A physician who specializes in the diagnosis, treatment, and management of allergies. Source: National Uniform Claim Committee

8933 ACTIVITY RD, San Diego, CA 92126

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Other Identifiers 3

Medicare UPINA40097CA

Medicare ID-Type UnspecifiedWG17502BCA

Medicaid00G175020CA

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. William W Wallace M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

RENEE FOMUSA DPT

Physical Therapist