Harvey I. Wallack, MD, a Medical Corporation

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

G26513 Issued in CA

Legal business name

HARVEY I. WALLACK, MD, A MEDICAL CORPORATION

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

Organization subpart

No

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

Authorized official

Name

Harvey I Wallack, M.D.NPI 1811096407

Title

President/Physician

Phone

(805) 496-4459

Specialties & licenses 1

Addresses

Practitioners 1

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

• Harvey I Wallack, M.D.

  • Urology Physician
  • Thousand Oaks, CA
  • NPI 1811096407
  NPD Authorized official

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1902905409",
    "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": {
        "organization_name": "HARVEY I. WALLACK, MD, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "WALLACK",
        "authorized_official_first_name": "HARVEY",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "805-496-4459",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "G26513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harry S Menco MD , Inc
• Harry S. Menco, M.D., Inc.
• Debbie Ray Hartke, LMT
• Bridget Downey Hartman, M.D.
• Lauren K Hartnett
• Kimberly Harvey, BCABA
• Irsa Shoiab Hasan, MD
• Mojgan Hashemi, D.D.S.
• Farhad Hashmi, MD
• Samuel Paul Haslam, MD

• 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 Dec 17, 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.