Individual
DR. WILLIAM H WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10243 GENETIC CENTER DR, SAN DIEGO, CA 92121-6310
(858) 526-6100
(858) 526-6126
Mailing address
10243 GENETIC CENTER DR, SAN DIEGO, CA 92121-6310
(858) 526-6100
(858) 526-6126
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G70189
CA
208D00000X
General Practice Physician
Primary
G70189
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G701890
—
CA
Enumeration date
08/31/2006
Last updated
06/27/2013
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