# SDPM MEDICAL GROUP, INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Other names:** San Diego Pain Management
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821640145
- **Authorized official:** ROBERT LEE WAGNER JR. MD (PRESIDENT)
- **Authorized official phone:** (858) 454-5442

## Contact information

- **Practice address:** 9850 GENESEE AVE STE 820, LA JOLLA, CA 92037-1219
- **Practice address phone:** (858) 454-5442
- **Practice address fax:** (858) 431-4633
- **Mailing address:** PO BOX 221048, SAN DIEGO, CA 92192-1048
- **Mailing address phone:** (858) 395-0309
- **Mailing address fax:** (858) 452-9027

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/16/2019
- **Last updated:** 01/07/2020