Individual
AMY C WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
18520 VIA PRINCESSA, SUITE C-2, CANYON COUNTRY, CA 91387-8326
(661) 424-0900
(661) 424-0924
Mailing address
18520 VIA PRINCESSA, SUITE C-2, CANYON COUNTRY, CA 91387-8326
(661) 424-0900
(661) 424-0924
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A70385
CA
Other
Enumeration date
07/24/2006
Last updated
07/08/2007
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