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Organization
EDWARD A, WAGNER, M.D., INC.
Active
Organization
EDWARD A, WAGNER, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD A WAGNER MD (PRESIDENT)
(949) 499-4540
Entity
Organization
Contact information
Practice address
25500 RANCHO NIGUEL RD STE 240, LAGUNA NIGUEL, CA 92677-7373
(949) 923-5117
(949) 715-4827
Mailing address
25500 RANCHO NIGUEL RD STE 240, LAGUNA NIGUEL, CA 92677-7373
(949) 499-4540
(949) 715-4827
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Enumeration date
08/27/2019
Last updated
09/17/2019
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