Individual
DR. LAWRENCE DAVID WAGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 SAN BERNARDINO ROAD, SUITE 1100, UPLAND, CA 91786-4952
(909) 949-2242
(909) 981-5783
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G55578
CA
2086X0206X
Surgical Oncology Physician
Primary
G55578
CA
Other
Enumeration date
09/03/2006
Last updated
04/19/2022
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