Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wallace Medical Group, Inc

Organization Procedural Dermatology Physician · NPI 1104047596

Wallace Medical Group, Inc is a Procedural Dermatology Physician in Beverly Hills, California. Licensed in California. Registered with an NPI since 2007.

Licensed in
CA
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8920 Wilshire Blvd Ste 327
Beverly Hills, CA 90211-2007
Phone: (310) 652-8460
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Procedural Dermatology Physician (primary) Taxonomy 207NS0135X · Licence A49918 (CA)

Record details

NPI number1104047596
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Wallace — Medical Director · (310) 652-8460
NPI enumeratedMay 1, 2007
Last updated in NPPESOctober 16, 2007
Mailing address8920 Wilshire Blvd, Suite 327, Beverly Hills, CA 90211-2007

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