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Contact Information

DENNIS J WALLACE, OD
662 EAST VISALIA ROAD
FARMERSVILLE, CA93223
 Phone: 559-747-3461
 Fax: 559-594-4059
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for DENNIS J WALLACE · (Male)

NPI Number 1699741777
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 02/27/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • CA License # OPT5964 TPA
  • MT License # 406OPT TPA
  • WA License # OD00001112
  • CA Medicaid SD0059641
  • Other SD0059640 BLUE SHIELD
  • CA Other 2868614 MEDICAL PASSWORD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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