Harvey I Wallack, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

G26513 Issued in CA

Practice address

227 W Janss Rd Ste 125
Thousand Oaks, CA 91360-1856

Phone

(805) 496-4459

Fax

(805) 496-3250

NPI assigned

Sep 21, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Harvey I. Wallack, MD, a Medical Corporation

  • Urology Physician
  • Thousand Oaks, CA
  • NPI 1902905409
  NPD Authorized official

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811096407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 W JANSS RD STE 125",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601856",
            "telephone_number": "805-496-4459",
            "fax_number": "805-496-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 W JANSS RD STE 125",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601856",
            "telephone_number": "805-496-4459",
            "fax_number": "805-496-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACK",
        "first_name": "HARVEY",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "G26513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn Eric Waldman, M.D.
• Donald Waldrep, M.D.
• Walgreen Co
• Sophia Julie Lynn Wall
• Erica Wallace
• Walmart Inc.
• Walter Alain Thomas M D Inc
• Rhandi Walters, LMFT
• Jeffrey Yin Wang, MD
• Ward L. Jones, M.D., a Medical Corp.

• Urology Physician in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.