David Carter Wallace, DO

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

20A25571 Issued in CA

Practice address

18250 Roscoe Blvd
Northridge, CA 91325-4226

Phone

(818) 796-2920

NPI assigned

Apr 9, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nephrology

Education

Touro Un Col of Osteopathic Medicine, Henderson, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ohio State University State Health System Hospital, Columbus, OH, CCN 360085
• James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dwallace1125194@direct.osumc.edu

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.

• Osu Internal Medicine, LLC

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1740231448
  Medicare reassignment NPD

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

• Arthur G James Cancer Hospital and Research Institute

  • Special Hospital
  • Columbus, OH
  • NPI 1124127683
  Care Compare affiliation
• Ohio State University Hospitals

  • Rehabilitation Hospital Unit
  • Columbus, OH
  • NPI 1184723637
  Care Compare affiliation
• Ohio State University Hospitals

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1447359997
  Care Compare affiliation
• Ohio State University Hospitals

  • Psychiatric Hospital Unit
  • Columbus, OH
  • NPI 1790876183
  Care Compare affiliation

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1396364402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-4837",
            "fax_number": "614-293-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18250 ROSCOE BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254226",
            "telephone_number": "818-796-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DAVID",
        "middle_name": "CARTER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "20A25571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walid S Arnaout MD a Medical Corporation
• Christian Walker
• Randy Walker
• David Wallace, PA-C
• Walmart, Inc.
• Walter E. Jacobson, MD, Inc.
• Debbie Wang, D.O.
• Jeffrey Chinwei Wang, D.O.
• Liang Wang, MD

• Nephrology Physician in Northridge, CA
• Providers in Northridge, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.