NPI: 1104394329 · EL CENTRO, CA 92243 · Pediatric Anesthesiology Physician · NPI assigned 11/06/2018
| Authorized Official | WALLACE, SCOTT (OWNER/PHYSICIAN) |
| NPI Enumeration Date | 11/06/2018 |
Other providers sharing the same authorized official: WALLACE, SCOTT
| Provider | City | State | Total Paid |
|---|---|---|---|
| PINE TREE CHIROPRACTIC PC | KLAMATH FALLS | OR | $54K |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 16 | $416.72 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 00142 | 16 | 16 | $416.72 |