Individual
DR. GLENN NORMAN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5570 OVERLAND AVE STE 101, SAN DIEGO, CA 92123-1215
(858) 694-2899
(858) 694-2514
Mailing address
5570 OVERLAND AVE STE 101, SAN DIEGO, CA 92123-1215
(858) 694-2899
(858) 694-2514
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
Primary
20A4111
CA
Other
Enumeration date
08/29/2017
Last updated
07/21/2022
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