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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1154085231

Miles Thomas Wallace, IDC is a Student in an Organized Health Care Education/Training Program in San Diego, California. Registered with an NPI since 2021.

In the registry since
2021
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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

San Diego, CA

No coordinates on file. Search this address in Google Maps

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1154085231
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorNo
NPI enumeratedOctober 26, 2021
Last updated in NPPESJanuary 5, 2022
Certification dateJanuary 5, 2022

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