Wallace, Grant Charles

Wallace, Grant Charles is an individual health care provider with primary practice located at 200 Mercy Circle , Oceanside CA 92055. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Wallace, Grant Charles can be contacted via phone (760) 719-3479.

Contact Information

Primary practice address
200 Mercy Circle Oceanside CA 92055
Phone: (760) 719-3479
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G80310 California

Profile Details

NPI number 1043208101
LBN Legal business name Wallace, Grant Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Sep 25th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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