Individual
ELIZABETH WAGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10833 LE CONTE AVE, STE B-186 CHS, LOS ANGELES, CA 90095-3075
(310) 794-8285
Mailing address
5767 W. CENTURY BLVD, #400, LOS ANGELES, CA 90045-5655
(310) 794-8285
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G48534
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G485340
—
CA
Enumeration date
07/03/2006
Last updated
06/21/2010
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