Wall Medical Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLIA # 05D0693988 Issued in CA

Legal business name

WALL MEDICAL INC

Practice address

455 Grand Ave
South San Francisco, CA 94080-3635

Phone

(650) 952-2420

Fax

(650) 871-8076

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Cathy Brooks

Title

Office Manager

Phone

(650) 636-1291

Specialties & licenses 1

Addresses

Other names 1

• PMC Laboratory Services Doing business as

Locations

Practitioners 1

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

• Catherine Wall, PT

  • Physical Therapist
  • South San Francisco, CA
  • NPI 1679516488
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224806400000",
    "number": "1740386309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 UNION ST",
            "address_2": "SUITE 300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941234114",
            "telephone_number": "415-447-6899",
            "fax_number": "415-447-6894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 GRAND AVE",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803635",
            "telephone_number": "650-952-2420",
            "fax_number": "650-871-8076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALL MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2008-10-24",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "650-636-1291"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLIA  # 05D0693988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PMC Laboratory Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Walgreen Co
• Walgreen Co
• Walgreens
• Walgreens Pharmacy
• Wall Medical Group
• Catherine Wall, PT
• Amy Wang
• Jung Wang, CCC-SLP
• Qingping Wang, M.D., PH.D.
• Judith Ann Ward, RN

• Clinical Medical Laboratory in South San Francisco, CA
• Providers in South San Francisco, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2008; 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.