Wagner, Luke Andrew

Wagner, Luke Andrew is an individual health care provider with primary practice located at 917 3Rd St , Coronado CA 92118-1313. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Wagner, Luke Andrew can be contacted via phone (305) 793-4777.

Contact Information

Primary practice address
917 3Rd St Coronado CA 92118-1313
Phone: (305) 793-4777
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Independent Duty Corpsman 1710I1002X

Profile Details

NPI number 1013589407
LBN Legal business name Wagner, Luke Andrew
Credentials SOIDC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2021
Last updated Jul 14th, 2021 - 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.

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