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Eric W Wallace

  • Male

Medical Specialty

Professional ID

  • NPI: 1578502191
  • PECOS ID: 3577506690
  • Enrollment ID: I20050608001128
  • Credential(MD, DO, DPM): MD
  • Medical School: Loma Linda University School Of Medicine
  • Medical School Graduation Year: 1999

Hospital Service

  • Hospital CCN1: 050159
  • Business Name (LBN)1: Ventura County Medical Center
  • Hospital CCN2: 050102
  • Business Name (LBN)2: Parkview Community Hospital Medical Center
  • Hospital CCN3: 050755
  • Business Name (LBN)3: Sherman Oaks Hospital
  • Hospital CCN4: 050298
  • Business Name (LBN)4: Barstow Community Hospital
  • Hospital CCN5: 050471
  • Business Name (LBN)5: Good Samaritan Hospital

Medical Practices

  • Organization Name: Renaissance Imaging Medical Associates Inc
  • Group Practice ID assigned by PECOS: 7315841756
  • Number of Group Practice member: 93

Location

  • Address1: 16143 Regency Ranch Rd
  • Address2:
  • City: Riverside
  • State: California
  • Zip Code: 92504
  • Phone Number: (616)916-7968

Location

  • Address1: 16237 Ventura Blvd
  • Address2:
  • City: Encino
  • State: California
  • Zip Code: 91436
  • Phone Number: (818)995-5245

Location

  • Address1: 16850 Bear Valley Rd
  • Address2:
  • City: Victorville
  • State: California
  • Zip Code: 92395
  • Phone Number: (760)241-8000

Location

  • Address1: 18300 Roscoe Blvd
  • Address2:
  • City: Northridge
  • State: California
  • Zip Code: 91325
  • Phone Number: (818)885-8500

Location

  • Address1: 18436 Roscoe Blvd
  • Address2:
  • City: Northridge
  • State: California
  • Zip Code: 91325
  • Phone Number: (818)885-3598

Location

Location

  • Address1: 3291 Loma Vista Rd
  • Address2:
  • City: Ventura
  • State: California
  • Zip Code: 93003
  • Phone Number: (805)652-6075

Location

  • Address1: 3865 Jackson St
  • Address2:
  • City: Riverside
  • State: California
  • Zip Code: 92503
  • Phone Number: (951)688-2211

Location

  • Address1: 44105 15th W St
  • Address2: Suite 100
  • City: Lancaster
  • State: California
  • Zip Code: 93534
  • Phone Number: (661)726-6226

Location

  • Address1: 501 S Buena Vista St
  • Address2:
  • City: Burbank
  • State: California
  • Zip Code: 91505
  • Phone Number: (818)843-5111

Location

  • Address1: 7889 Wheeler Canyon Rd
  • Address2:
  • City: Santa Paula
  • State: California
  • Zip Code: 93060
  • Phone Number: (805)651-8465

Location

  • Address1: 820 E Mountain View St
  • Address2:
  • City: Barstow
  • State: California
  • Zip Code: 92311
  • Phone Number: (760)256-1761

Location

  • Address1: 825 N 10th St
  • Address2:
  • City: Santa Paula
  • State: California
  • Zip Code: 93060
  • Phone Number: (805)933-8674

Medical Practices

  • Organization Name: Northern Inyo Healthcare District
  • Group Practice ID assigned by PECOS: 8921992090
  • Number of Group Practice member: 45

Location

  • Address1: 150 Pioneer Ln
  • Address2:
  • City: Bishop
  • State: California
  • Zip Code: 93514
  • Phone Number: (760)873-5811

Medicare

  • Medicare Assignment: Yes
  • Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
  • Used Electronic health record (EHR):