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Individual

DR. CARL WAGREICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
23451 MADISON ST, STE 230, TORRANCE, CA 90505-4761
(310) 373-0521
(310) 791-1691
Mailing address
23451 MADISON ST, STE 230, TORRANCE, CA 90505-4761
(310) 373-0521
(310) 791-1691

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
E2415
CA
213EP1101X
Primary Podiatric Medicine Podiatrist
E2415
CA
213ER0200X
Radiology Podiatrist
E2415
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E2415
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E24150
CA
Enumeration date
05/23/2005
Last updated
10/30/2009
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