Individual
LLOYD DAVID WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
223 24TH ST, SANTA MONICA, CA 90402-2515
(952) 595-1100
(612) 294-4903
Mailing address
223 24TH ST, SANTA MONICA, CA 90402-2515
(888) 886-5238
(888) 886-9330
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
164449
NY
2085R0202X
Diagnostic Radiology Physician
Primary
25MA09610500
NJ
2085R0202X
Diagnostic Radiology Physician
53879
CT
2085R0202X
Diagnostic Radiology Physician
G70226
CA
2085R0202X
Diagnostic Radiology Physician
TM2014-0943
NM
Other
Enumeration date
02/14/2007
Last updated
04/21/2026
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