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

David Wallace, PA-C

Individual provider Physician Assistant · NPI 1730852179

David Wallace, PA-C is a Physician Assistant in Northridge, California. Qualified in 2021, 5 years ago. Practices with United Medical Doctors, a 169-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

18350 Roscoe Blvd # 702
Northridge, CA 91325-4109
Phone: (818) 280-5961
Fax: (818) 280-5983
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA59863 (CA)

Record details

NPI number1730852179
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 30, 2021
Last updated in NPPESAugust 28, 2025
Certification dateAugust 28, 2025
Mailing address18350 Roscoe Blvd # 702, Northridge, CA 91325-4109

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice United Medical Doctors — 169 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Northridge