Individual
DAVID D WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1555 SOQUEL DR, SANTA CRUZ, CA 95065-1705
(831) 462-7700
Mailing address
2100 POWELL ST, SUITE 900, EMERYVILLE, CA 94608-1826
(510) 851-7441
(510) 879-9077
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
9149605-1205
UT
207P00000X
Emergency Medicine Physician
Primary
A142670
CA
Other
Enumeration date
04/19/2013
Last updated
07/13/2016
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