Individual
DR. STEPHEN JOHN WAGSTAFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1321 SOUTH ELISEO DRIVE, GREENBRAE, CA 94904
(415) 925-1150
(415) 925-1154
Mailing address
1321 SOUTH ELISEO DRIVE, GREENBRAE, CA 94904
(415) 925-1150
(415) 925-1154
Taxonomy
Speciality
Code
Description
License number
State
213ES0000X
Sports Medicine Podiatrist
E4439
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4439
CA
Other
Enumeration date
07/05/2005
Last updated
02/18/2022
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