Wagner, Barry Alan

Wagner, Barry Alan is an sole proprietor health care provider with primary practice located at 12229 Ventura Blvd , Studio City CA 91604-2576. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wagner, Barry Alan can be contacted via phone (818) 880-2020.

Contact Information

Primary practice address
12229 Ventura Blvd Studio City CA 91604-2576
Phone: (818) 880-2020
Fax: (818) 880-1888
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 5104TLG California

Profile Details

NPI number 1922071646
LBN Legal business name Wagner, Barry Alan
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 13th, 2006
Last updated Dec 22nd, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922071646 NPPES
California MEDICAID GSD005410
California MEDICAID SD0051040

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