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:
Health care specialties
| Specialty | Code | License # | 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 3 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 | 1922071646 | NPPES |
| California | MEDICAID | GSD005410 | |
| California | MEDICAID | SD0051040 |
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