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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

WALLACE B CARROLL, MD

Active

WALLACE B CARROLL, MD is a Allergy healthcare provider located in MODESTO, California. NPI 1003874124 is currently active in the NPPES registry. Verify at CMS.

Allergy · MODESTO, CA

Registration Details

NPI Number
1003874124
Provider Type
Individual
Gender
Male
NPI Issued
May 1, 2006 (20.286456112081 yrs)
Last Updated
May 28, 2010
Licenses
A31444 (CA)
A31444 (CA)

Practice Information

Address
600 COFFEE RD
MODESTO, CA, 953554201
Browse CA providers · Browse ZIP 95355
Phone
2095241211
Primary Specialty
Allergy
207KA0200X
Additional Specialty
Pediatrics
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.