Wagner, David
Wagner, David is an individual health care provider with primary practice located at 91 Gregory Ln Suite 15, Pleasant Hill CA 94523-4981. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Wagner, David can be contacted via phone (925) 685-0843.Contact Information
Primary practice address
91 Gregory Ln Suite 15
Pleasant Hill CA 94523-4981
Phone: (925) 685-0843
Fax: (925) 685-1899
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | G55652 | California |
Profile Details
| NPI number | 1700804077 |
|---|---|
| LBN Legal business name | Wagner, David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Jun 21st, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700804077 | NPPES |
| California | MEDICAID | 00G556520 |
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