Dr Timothy Mark Wallace, DC is a medicare enrolled "Chiropractor" provider in Phelan, California. He went to Los Angeles College Of Chiropractic and graduated in 1999 and has 25 years of diverse experience with area of expertise as Chiropractic. His current practice location is
4357 Phelan Rd, Phelan, California. You can reach out to his office (for appointments etc.) via phone at
(760) 868-4481.
Dr Timothy Mark Wallace is licensed to practice in California (license number 23400) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1063438307.
Healthcare Provider's Profile
| Full Name | Dr Timothy Mark Wallace |
|---|
| Gender | Male |
|---|
| Speciality | Chiropractic |
|---|
| Experience | 25 Years |
|---|
| Location | 4357 Phelan Rd, Phelan, California |
|---|
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Dr Timothy Mark Wallace attended and graduated from Los Angeles College Of Chiropractic in 1999
NPI Data:
- NPI Number: 1063438307
- Provider Enumeration Date: 07/13/2006
- Last Update Date: 01/27/2012
Medicare PECOS Information:
- PECOS PAC ID: 8628238573
- Enrollment ID: I20120329000730
Medical Identifiers
Medical identifiers for Dr Timothy Mark Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063438307 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | 23400 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Timothy Mark Wallace is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Timothy Mark Wallace, DC
4357 Phelan Rd,
Phelan, CA 92371-7675
Ph: (760) 868-4481 | Dr Timothy Mark Wallace, DC
4357 Phelan Rd,
Phelan, CA 92371-7675
Ph: (760) 868-4481 |
Reviews and Comments