| Eric Wallace, MD | |
|
168 N Brent St, Suite 402, Ventura, CA 93003-2817 | |
| (888) 234-0004 | |
| (805) 641-3965 |
| Full Name | Eric Wallace |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 26 Years |
| Location | 168 N Brent St, Ventura, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578502191 | NPI | - | NPPES |
| 00A851950 | Other | CA | BLUESHIELD OF CA |
| 00A851950 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | A85195 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Central Peninsula General Hospital | Soldotna, AK | Hospital |
| Skagit Valley Hospital | Mount vernon, WA | Hospital |
| Island Hospital | Anacortes, WA | Hospital |
| Whidbeyhealth Medical Center | Coupeville, WA | Hospital |
| Cascade Valley Hospital | Arlington, WA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Whidbey Island Public Hospital District | 1658280680 | 90 |
| Skagit Digital Imaging Llc | 4486543204 | 26 |
| Jefferson County Public Hospital District No 2 | 4789593708 | 104 |
| Skagit Radiology Inc P S | 7113815218 | 32 |
| Bellingham Advanced Medical Imaging Llc | 9739446824 | 23 |
| Whidbey Island Public Hospital District | 1658280680 | 90 |
| Fairbanks Medical Imaging Llc | 4082894407 | 20 |
| Skagit Digital Imaging Llc | 4486543204 | 26 |
| Jefferson County Public Hospital District No 2 | 4789593708 | 104 |
| Skagit Radiology Inc P S | 7113815218 | 32 |
| North Star Medical Imaging Pllc | 7214005099 | 24 |
| Bellingham Advanced Medical Imaging Llc | 9739446824 | 23 |
| Entity Name | Jefferson County Public Hospital District No 2 |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356492953 PECOS PAC ID: 4789593708 Enrollment ID: O20031111000542 |
| Entity Name | Whidbey Island Public Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710927231 PECOS PAC ID: 1658280680 Enrollment ID: O20040210000761 |
| Entity Name | Skagit Radiology Inc P S |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932218757 PECOS PAC ID: 7113815218 Enrollment ID: O20040309001447 |
| Entity Name | Skagit Digital Imaging Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043328636 PECOS PAC ID: 4486543204 Enrollment ID: O20040311000384 |
| Entity Name | North Star Medical Imaging Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144489824 PECOS PAC ID: 7214005099 Enrollment ID: O20090630000392 |
| Entity Name | Fairbanks Medical Imaging Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528360625 PECOS PAC ID: 4082894407 Enrollment ID: O20110225000012 |
| Entity Name | Bellingham Advanced Medical Imaging Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730605965 PECOS PAC ID: 9739446824 Enrollment ID: O20171129002456 |
| Entity Name | Iliuliuk Family And Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376520692 PECOS PAC ID: 5294635165 Enrollment ID: O20231030001236 |
| Mailing Address | Practice Location Address |
|---|---|
| Eric Wallace, MD 4100 Guardian St, Ste 205, Simi Valley, CA 93063-6721 Ph: (855) 504-4544 | Eric Wallace, MD 168 N Brent St, Suite 402, Ventura, CA 93003-2817 Ph: (888) 234-0004 |
Dr. John Mcmahan, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 3291 Loma Vista Rd, Ventura, CA 93003 Phone: 805-652-6556 | |
Dr. Bruce Matthews, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 3291 Loma Vista Rd, Ventura, CA 93003 Phone: 805-652-6556 | |
Dr. Duke K Bahn, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 168 N Brent St, #402, Ventura, CA 93003 Phone: 888-234-0004 Fax: 888-641-3965 | |
Kyu Choi, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 147 N Brent St, Radiology Department, Ventura, CA 93003 Phone: 805-652-5028 | |
Dr. Matthew Carr, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3291 Loma Vista Rd, Ventura, CA 93003 Phone: 805-652-6556 | |
Dr. Reed M. Horwitz, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 3291 Loma Vista Rd, Department Of Radiology Vcmc, Ventura, CA 93003 Phone: 805-652-6080 Fax: 805-652-3399 |