David Wallis, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A77627 Issued in CA

Practice address

520 N Prospect Ave Ste 309
Redondo Beach, CA 90277-3043

Phone

(424) 437-4700

Fax

(424) 437-8884

NPI assigned

May 17, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Sports Medicine

Education

University of California, San Diego School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

David Wallis Medical CorporationGroup PAC ID 4688065154, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351
• Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• David Wallis Medical Corporation

  • Internal Medicine Physician
  • Redondo Beach, CA
  • NPI 1629736384
  Medicare reassignment Care Compare group NPD Authorized official
• Torrance Health Association Inc

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1083903124
  Medicare reassignment
• Providence Health System Southern California

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1902844988
  NPD (past)
• Torrance Memorial Medical Center

  • Skilled Nursing Facility
  • Torrance, CA
  • NPI 1740268713
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health System Southern California

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1902844988
  Care Compare affiliation
• Torrance Memorial Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1467459776
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1255383139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66657",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981660657",
            "telephone_number": "424-437-4700",
            "fax_number": "424-437-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE STE 309",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773043",
            "telephone_number": "424-437-4700",
            "fax_number": "424-437-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIS",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A77627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A776270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Graceann Frances Walker, LMFT
• Irene H Walker
• Jolee Walker, M.A., LMFT
• Celeste Orozco Wallace
• Jennifer Marie Wallace, L.A.C
• Robert Walls, RN, ATC,CES,PES,FRC
• Ian K Wallsh, P.T.
• Adam Walsh
• Amanda Victoria Walsh
• Gerald Walsh

• Internal Medicine Physician in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.