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

Robert Wallace, PA, NP

Individual provider Physician Assistant · NPI 1720315336

Robert Wallace, PA, NP is a Physician Assistant in Oakland, California. Licensed in California. Registered with an NPI since 2009.

Licensed in
CA
In the registry since
2009
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

747 52nd St
Oakland, CA 94609-1809
Phone: (510) 428-3022
Fax: (510) 428-3022
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 19738 (CA)
Physician Assistant Taxonomy 363A00000X · Licence PA20650 (CA)

Record details

NPI number1720315336
Entity typeIndividual (Type 1)
GenderMale
Credentials PA , NP
Sole proprietorNo
NPI enumeratedNovember 3, 2009
Last updated in NPPESJune 11, 2012

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