Individual
DR. LEONARD ROBERT WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4955 VAN NUYS BLVD, SUITE 107, SHERMAN OAKS, CA 91403
(818) 995-8228
(818) 995-1539
Mailing address
4955 VAN NUYS BLVD, SUITE 107, SHERMAN OAKS, CA 91403
(818) 995-8228
(818) 995-1539
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E1949
CA
Other
Enumeration date
12/19/2006
Last updated
04/04/2012
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