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MILES THOMAS WALLACE IDC
NPI 1154085231
Student in an Organized Health Care Education/Training Program in San Diego, CA

Active since October 26, 2021
34800 BOB WILSON DR, SAN DIEGO, CA 92134(619) 532-6400 Get Directions Write a Review

NPPES record last updated: January 5, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Miles Thomas Wallace Idc NPPES

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

MILES THOMAS WALLACE IDC (NPI 1154085231) is an individual student in an organized health care education/training program in San Diego, California and active in the NPI registry since October 2021.

NPPES Registry Identity

NPI1154085231
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMILES THOMAS WALLACECredential: IDC
Location Address34800 BOB WILSON DRSan Diego, CA 92134-1098
Mailing Address34800 Bob Wilson DrSan Diego, CA 92134-1098 · (619) 532-6400
Phone(619) 532-6400
Sole ProprietorNo
Enumeration DateOctober 26, 2021
Last NPPES UpdateJanuary 5, 2022
NPPES CertifiedJanuary 5, 2022
✔ NPI 1154085231 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
34800 BOB WILSON DR, San Diego, CA 92134
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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.

LORENA MARIE FUJII N.P.
Nurse Practitioner (Pediatrics)
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (619) 532-8910
LAKIESHA NICOLE MURPHY
Nurse's Aide
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (619) 713-3385
SUSANNA BYRNE D.O.
Anesthesiology
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (619) 532-6400
DR. PAUL CHARLES CAMPBELL D.O.
Urology (Pediatric Urology)
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (619) 532-7200
PHILLIP EDWARD FRY JR. DO
Emergency Medicine
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (619) 532-6400
BRADLY JAMES STILLEY IDC
Military Health Care Provider (Independent Duty Corpsman)
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (360) 941-9989
DR. ELIZABETH WHIPPLE PHD
Military Health Care Provider
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (619) 532-6400
DR. ELAN HARDER BRESSLOUR-RASHAP MD
General Practice
34800 BOB WILSON DR
SAN DIEGO, CA 92134
San Diego County (619) 532-6400

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 Miles Wallace's NPI number?

The NPI number for Miles Wallace is 1154085231. It was assigned to this individual provider in the NPPES registry on October 26, 2021.

Where is Miles Wallace located?

Miles Wallace practices at 34800 Bob Wilson Dr, San Diego, CA 92134. The listed phone number is (619) 532-6400.

What is Miles Wallace's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Miles Wallace was last updated on January 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.