Mark Wallace
Medical Specialty
Professional ID
- NPI: 1427098102
- PECOS ID: 4385831031
- Enrollment ID: I20101208000219
- Credential(MD, DO, DPM):
- Medical School: Creighton University School Of Medicine
- Medical School Graduation Year: 1987
Hospital Service
- Hospital CCN1: 050025
- Business Name (LBN)1: University Of California San Diego Medical Center
Medical Practices
- Organization Name: Regents Of The University Of California - Ucsd Medical Group
- Group Practice ID assigned by PECOS: 3577476761
- Number of Group Practice member: 1330
Location
- Address1: 200 W Arbor Dr
- Address2:
- City: San Diego
- State: California
- Zip Code: 92103
- Phone Number: (619)543-5733
Location
- Address1: 3855 Health Sciences Dr
- Address2:
- City: La Jolla
- State: California
- Zip Code: 92093
- Phone Number: (619)543-5733
Location
- Address1: 9300 Campus Point Dr
- Address2:
- City: La Jolla
- State: California
- Zip Code: 92037
- Phone Number: (619)543-5733
Location
- Address1: 9350 Campus Point Dr
- Address2:
- City: La Jolla
- State: California
- Zip Code: 92037
- Phone Number: (619)543-1899
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
- Used Electronic health record (EHR): Yes