OrganizationActive
Mark S. Wallen, D.P.M., Inc.
NPI 1629009055 · Foot Surgery Podiatrist · Santa Monica, CA
Provider details
- NPI number
- 1629009055
- Entity type
- Organization
- Primary specialty
- Foot Surgery PodiatristPodiatric Medicine & Surgery Service Providers
- Organization subpart
- No
- Authorized official
- Mark Wallen, Owner(310) 828-0122
- License
- E 3104 (CA)
Specialties & taxonomies
Podiatric Medicine & Surgery Service Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% 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
2001 Santa Monica Blvd
1190 W
Santa Monica, CA 90404-2102
Phone: (310) 828-0122
Fax: (310) 828-4463
Approximate (ZIP-level) locationGet directions
Mailing address
2001 Santa Monica Blvd
Santa Monica, CA 90404-2102
Registry dates
- Enumerated
- 2006-07-05
- Last updated
- 2009-11-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.