Individual
DR. JUSTIN B WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1650 CREEKSIDE DR, FOLSOM, CA 95630-3400
(916) 983-7470
Mailing address
2100 POWELL ST, STE 900, EMERYVILLE, CA 94608-1844
(909) 499-3611
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A101997
CA
Other
Enumeration date
05/13/2007
Last updated
06/30/2016
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