Adam Wallach,M.D. a Professional Corporation

Key facts

NPI

1346517620

Entity type

Organization (NPI type 2)

Primary specialty

Specialist 174400000X

License

G85998 (CA)

Legal business name

ADAM WALLACH,M.D. A PROFESSIONAL CORPORATION

Practice address

400 El Cerro Blvd.
Ste. 204
Danville, CA 94526

Phone

(925) 837-8848

NPI assigned

Nov 30, 2011

Organization subpart

No

Authorized official

Name

Adam G Wallach, M.D. NPI 1982741021

Title

Physican/Owner

Phone

(925) 837-8848

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adam Gregory Wallach, M.D. Procedural Dermatology Physician · Danville, CA · NPI 1982741021
  Medicare reassignment Care Compare group NPD Authorized official CA · SINGLE SPECIALTY
• Kathryn Ann Vancleave, FNP Family Nurse Practitioner · Encinitas, CA · NPI 1144377342
  Medicare reassignment Care Compare group NPD CA
• Sarah Elizabeth Broome, PA Physician Assistant · Oakley, CA · NPI 1174962054
  Medicare reassignment CA

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CA

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 30, 2011.

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1346517620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EL CERRO BLVD.",
            "address_2": "STE. 204",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "94526",
            "telephone_number": "925-837-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 EL CERRO BLVD.",
            "address_2": "STE. 204",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "94526",
            "telephone_number": "925-837-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADAM WALLACH,M.D. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "WALLACH",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICAN/OWNER",
        "authorized_official_telephone_number": "925-837-8848",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G85998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, CA

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• Lwam Abraha
• Amelia Jane Academia, CMT
• Phyllis Wang Acon, M.D.
• Action in Motion Inc
• Jessica Adame, BI
• Brian Russell Adams, D.D.S.
• Steven John Adams, DC
• Shilpa Adlapalli
• Adrienne U. Feyock DDS, Inc.

All providers in Danville, CA · Specialist in California