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Organization
SDPM MEDICAL GROUP, INCORPORATED
Active
Organization
SDPM MEDICAL GROUP, INCORPORATED
Active
Other names
San Diego Pain Management
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT LEE WAGNER JR. MD (PRESIDENT)
(858) 454-5442
Entity
Organization
Contact information
Practice address
9850 GENESEE AVE STE 820, LA JOLLA, CA 92037-1219
(858) 454-5442
(858) 431-4633
Mailing address
PO BOX 221048, SAN DIEGO, CA 92192-1048
(858) 395-0309
(858) 452-9027
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
07/16/2019
Last updated
01/07/2020
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