IndividualActive
Alec Wallace, DO
NPI 1487242087 · General Practice Physician · Travis Afb, CA
Provider details
- NPI number
- 1487242087
- Entity type
- Individual
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- Yes
- License
- 02008162A (IN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
101 Bodin Cir
Travis Afb, CA 94535-1809
Phone: (707) 423-3000
Approximate (ZIP-level) locationGet directions
Mailing address
101 Bodin Cir
Travis Afb, CA 94535-1809
Registry dates
- Enumerated
- 2021-01-08
- Last updated
- 2026-01-21
- Certified
- 2026-01-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.