Wagner, Gary
Wagner, Gary is an individual health care provider with primary practice located at 600 Coffee Rd , Modesto CA 95355-4201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Wagner, Gary can be contacted via phone (209) 524-1211.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | A24987 | California |
Profile Details
| NPI number | 1235160102 |
|---|---|
| LBN Legal business name | Wagner, Gary |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2006 |
| Last updated | Apr 1st, 2016 - about 8 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 | 1235160102 | NPPES |
| California | MEDICAID | 00A249871 |
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