What is Justin Wallace's NPI number?

Justin Wallace's National Provider Identifier (NPI) is 1114354156, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Justin Wallace's specialty?

Justin Wallace is listed in the NPPES registry with a primary specialty of Independent Duty Corpsman (Other Service Providers).

Where is Justin Wallace located?

Justin Wallace's practice location on file with NPPES is 699 14th St, San Diego, CA 92101-7586.

What is Justin Wallace's phone number?

The practice phone number listed in the NPPES registry for Justin Wallace is (760) 845-8116.

Is Justin Wallace's NPI active?

Yes — Justin Wallace's NPI (1114354156) is active in the NPPES registry as of the last update on 2013-10-06.

IndividualActive

Justin Wallace, DIVE IDC

NPI 1114354156 · Independent Duty Corpsman · San Diego, CA

Justin Wallace, DIVE IDC is a Independent Duty Corpsman provider in San Diego, CA (NPI 1114354156).

Provider details

NPI number: 1114354156
Entity type: Individual
Primary specialty: Independent Duty CorpsmanOther Service Providers
Credential: DIVE IDC
Sex: Male
Sole proprietor: No

Specialties & taxonomies

Independent Duty CorpsmanPrimary1710I1002X
Other Service Providers

Profile Score

Established profile(70/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
12 yrs in NPPES registry
Profile completeness38% of score
83% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

699 14th St

San Diego, CA 92101-7586

Phone: (760) 845-8116

Street-level locationGet directions

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Mailing address