Wallace, Kevin Peter Scott

Wallace, Kevin Peter Scott is an individual health care provider with primary practice located at 1300 Crane St , Menlo Park CA 94025-4260. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Wallace, Kevin Peter Scott can be contacted via phone (650) 498-6500.

Contact Information

Primary practice address
1300 Crane St Menlo Park CA 94025-4260
Phone: (650) 498-6500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X C151609 California

Profile Details

NPI number 1255309258
LBN Legal business name Wallace, Kevin Peter Scott
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Apr 24th, 2024 - about 2 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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Identifiers

StateTypeNumberIssuer
All States NPI 1255309258 NPPES
Delaware MEDICAID 0000992201

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