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DAVID WALLACE PA-C
NPI 1730852179
Physician Assistant in Northridge, CA

Active since July 30, 2021PECOS EnrolledAccepts Medicare Assignment
18350 ROSCOE BLVD # 702, NORTHRIDGE, CA 91325(818) 280-5961(818) 280-5983 Get Directions Write a Review

NPPES record last updated: August 28, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About David Wallace Pa-c NPPES

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

DAVID WALLACE PA-C (NPI 1730852179) is an individual physician assistant in Northridge, California, licensed in California (PA59863) and active in the NPI registry since July 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in Culver City, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1730852179
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameDAVID WALLACECredential: PA-C
Location Address18350 ROSCOE BLVD # 702Northridge, CA 91325-4109
Mailing Address18350 Roscoe Blvd # 702Northridge, CA 91325-4109 · (818) 280-5961
Phone(818) 280-5961
Fax(818) 280-5983
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJuly 30, 2021
Last NPPES UpdateAugust 28, 2025
NPPES CertifiedAugust 28, 2025
✔ NPI 1730852179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · PA59863
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
18350 ROSCOE BLVD # 702, Northridge, CA 91325
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Secondary Practice Location 1

Location 15555 Inglewood BlvdCulver City, CA 90230-6226 · Phone (424) 532-1552 · Fax (888) 247-7249

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

David Wallace Pa-c 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 ID8325543770
PECOS Enrollment IDI20250925003294
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 91325 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
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.

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 David Wallace's NPI number?

The NPI number for David Wallace is 1730852179. It was assigned to this individual provider in the NPPES registry on July 30, 2021.

Where is David Wallace located?

David Wallace practices at 18350 Roscoe Blvd # 702, Northridge, CA 91325. The listed phone number is (818) 280-5961.

What is David Wallace's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is David Wallace enrolled in Medicare?

Yes. David 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 David Wallace was last updated on August 28, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.