Individual
SANGEETA S. WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5265 VISTA BLVD BLDG B, SPARKS, NV 89436-0836
(775) 352-5335
(775) 352-5334
Mailing address
PO BOX 740433, LOS ANGELES, CA 90074-0433
(775) 352-5335
(775) 352-5334
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1038
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11426504
CAQH
—
05
—
1205809365
—
NV
Enumeration date
02/09/2006
Last updated
05/11/2020
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