Adam Bryan Wallace, MD
Plastic Surgery in Stanford, CA. Individual provider (NPI-1).
NPI number1700317898
StatusActive
Last updated in NPPESAug 3, 2025
Details
- NPI
- 1700317898
- Entity type
- Individual (NPI-1)
- Name
- Adam Bryan Wallace
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 21, 2017
- Certification date
- Aug 3, 2025
- Last updated
- Aug 3, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208200000X | Plastic Surgery | A161405 | CA | Yes |
Practice location
300 Pasteur DrStanford, CA 94305-2200
Phone 650-723-4000
Mailing address
300 Pasteur DrStanford, CA 94305-2200
Phone 650-723-4000
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