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
Phone: (209) 484-8516
Fax: (209) 576-3613
Website:
Health care specialties
| Specialty | Code | License # | 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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