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

Individual provider Orthopaedic Surgery Physician · NPI 1144229600

Dr. Charles Douglas Wallace, MD is an Orthopedic Surgery in San Diego, California. Graduated from University of Michigan Medical School in 1988, 38 years ago. Practices with Rady Children's Hospital San Diego, a 161-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
38
Trained at
University of Michigan Medical School
Licensed in
CA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3030 Childrens Way Ste 410
San Diego, CA 92123-4232
Phone: (858) 966-6789
Fax: (858) 966-8519
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence G67953 (CA)

Record details

NPI number1144229600
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 18, 2005
Last updated in NPPESNovember 2, 2011

Medicare enrollment

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

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolUNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduated 1988 (38 years in practice)
Group practice Rady Children'S Hospital San Diego — 161 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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