Individual
MR. DAVID A WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1340 TULLY RD, SUITE 304, SAN JOSE, CA 95122-3055
(408) 271-3900
(408) 271-3909
Mailing address
1340 TULLY RD, SUITE 304, SAN JOSE, CA 95122-3055
(408) 271-3900
(408) 271-3909
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/12/2009
Last updated
11/12/2009
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