Individual
LINDSAY DAVIES WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2700 GRANT ST STE 106, CONCORD, CA 94520-2280
(925) 937-1770
Mailing address
1450 TREAT BLVD # 300, WALNUT CREEK, CA 94597-2168
(925) 952-2828
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA19381
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA19381
PA LICENSE NUMBER
CA
Enumeration date
11/19/2007
Last updated
02/08/2023
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