Individual provider · Type 1 NPI

David Wallace, PA-C

Physician Assistant · Northridge, CA

NPI number 1730852179 Active

Practice location

18350 Roscoe Blvd # 702
Northridge, CA 91325-4109

Call (818) 280-5961 Map

Fax (818) 280-5983

Other practice locations

  • 5555 Inglewood Blvd, Culver City, CA 90230-6226 · (424) 532-1552

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XPA59863 (CA)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1730852179

David Wallace, PA-C's National Provider Identifier is 1730852179, issued on Jul 30, 2021. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Northridge, CA. The record was last updated on Aug 28, 2025.