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Johnny Wallace
NPI 1750021978 · on the registry since 2022 · sole proprietor
Practice
- Address
- 1411 W 190th St
Gardena, CA 90248 - Phone
- (562) 210-6842
- Organisation at this address
- Drew Child Development Corporation
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 315
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Sex
- Male
- Record last updated
- 2022-03-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California