Steven B Wallach DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2113 Issued in AZ

Legal business name

STEVEN B WALLACH DO

Practice address

3005 W Ina Rd
Suite 123
Tucson, AZ 85741-2107

Phone

(520) 575-9110

Fax

(520) 575-8033

NPI assigned

Mar 23, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steven B Wallach, DONPI 1114027117

Title

Sole Proprietor

Phone

(520) 575-9110

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven B Wallach, D.O.

  • Family Medicine Physician
  • Tucson, AZ
  • NPI 1114027117
  NPD (past) Authorized official

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376660241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 W INA RD",
            "address_2": "SUITE 123",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857412107",
            "telephone_number": "520-575-9110",
            "fax_number": "520-575-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 W INA RD",
            "address_2": "SUITE 123",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857412107",
            "telephone_number": "520-575-9110",
            "fax_number": "520-575-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN B WALLACH DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "520-575-9110",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "2113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260703",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Jason Stern, PTA
• Beth Sternberg
• Jane Marie Steuart, RN, NP
• Steven a Swidler DDS PC (Medicine Wheel Dental)
• Steven a Wool MD Personalized Healthcare of Arizona PLLC
• Steven B. Hollander DPM LLC
• Steven E Behr MD PC
• Steven F. Kammeyer D.D.S. Inc
• Steven G. Vaughan MD, PC
• Steven Weisman O.D., P.C. (Optical Image by Dr. Weisman)

• Family Medicine Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.