DR. KORI L WALLACE MD PHD NPI 1477843662

NPI Information

DR. Kori L Wallace, MD, PHD is a student in an organized health care education training program in Los Angeles, CA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Kori L Wallace, MD, PHD NPI is 1477843662. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

757 WESTWOOD PLZ
B711 RRUMC
LOS ANGELES, CA
ZIP 90095-126
Phone: (310) 267-9128

The enumeration date for this NPI number is 4/9/2011 and was last updated on 4/9/2011.

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:

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