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Organization

LEONARD R WAGNER DPM A PROFESSIONAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEONARD R WAGNER DPM (PRESIDENT)
(818) 995-8228
Entity
Organization

Contact information

Practice address
4955 VAN NUYS BLVD, SUITE 107, SHERMAN OAKS, CA 91403-1801
(818) 995-8228
(818) 995-1539
Mailing address
4955 VAN NUYS BLVD, SUITE 107, SHERMAN OAKS, CA 91403-1801
(818) 995-8228
(818) 995-1539

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary

Other

Enumeration date
01/12/2011
Last updated
01/12/2011
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