Individual
GARY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 521-6097
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A24987
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A249871
—
CA
Enumeration date
07/06/2006
Last updated
04/01/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us