Wallace, Sylvester Lee
Wallace, Sylvester Lee is an individual health care provider with primary practice located at 21935 Van Buren St Ste A1 , Grand Terrace CA 92313-5652. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, Other Service Providers / Community Health Worker. Other Service Providers / Community Health Worker is his primary health care specialty. Wallace, Sylvester Lee can be contacted via phone (909) 906-1023.Contact Information
Primary practice address
21935 Van Buren St Ste A1
Grand Terrace CA 92313-5652
Phone: (909) 906-1023
Fax: (909) 906-1032
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner | 225400000X | ||
| Other Service Providers / Community Health Worker | 172V00000X | NONE |
Profile Details
| NPI number | 1427827625 |
|---|---|
| LBN Legal business name | Wallace, Sylvester Lee |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 28th, 2023 |
| Last updated | Feb 22nd, 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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