Individual
DR. BURL WAGENHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
7601 IMPERIAL HWY, HB 226, DOWNEY, CA 90242-3456
(562) 401-6320
Mailing address
PO BOX 3335, SEAL BEACH, CA 90740-2335
(562) 401-6329
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 16594
CA
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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