Wagner, Paul Brooks

Wagner, Paul Brooks is an sole proprietor health care provider with primary practice located at 1836 Harbor Cv , Modesto CA 95355-1856. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Vascular Specialist, which is considered as his primary health care specialty. Wagner, Paul Brooks can be contacted via phone (209) 484-8516.

Contact Information

Primary practice address
1836 Harbor Cv Modesto CA 95355-1856
Fax: (209) 576-3613
Website:

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Vascular Specialist 246XC2903X 890191-0970 Mississippi

Profile Details

NPI number 1518063916
LBN Legal business name Wagner, Paul Brooks
Credentials Certified Clinical Perfusionist (CCP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 15th, 2006
Last updated Jul 8th, 2007 - about 19 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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