Provider Type Icon

DR. ROGER CHARLES WALLACE M.D. NPI 1083645501


NPI Information

NPI: 1083645501
Provider Name: DR. ROGER CHARLES WALLACE, M.D.
Classification: Emergency Medicine - 207P00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
23845 MCBEAN PKWY
VALENCIA, CA
ZIP 91355
Phone: (661) 253-8112
Get Directions

DR. Roger Charles Wallace, M.D. is an emergency medicine in Valencia, CA with 26 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. DR. Roger Charles Wallace, M.D. NPI is 1083645501. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Graduation Year:1998

The provider's business location address is:

23845 MCBEAN PKWY
VALENCIA, CA
ZIP 91355-001
Phone: (661) 253-8112
Fax: (661) 253-8119

The NPI 1083645501 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Interpretation and report of electrical activity of heart using 1-3 leads (HCPCS:93042)

The enumeration date for this NPI number is 7/5/2006 and was last updated on 7/7/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207P00000XEmergency MedicineA71306CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H68110MEDICARE UPINCALIFORNIA
2WA71306BMEDICARE PINCALIFORNIA
300A713060MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.