Mr. Willis H. Wagner
Vascular Surgeon
8631 W 3rd St Suite 615e
Los Angeles
, California 90048-5901
Mr. Willis H. Wagner
Vascular Surgeon
8631 W 3rd St Suite 615e
Los Angeles
, California 90048-5901
(310) 659-3815
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About
Features
Specialties
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- Mr. Willis H. Wagner
- 8631 W 3rd St Suite 615e
- Los Angeles, CA
- Zip : 90048-5901
- Fax : (310) 659-3815
- Phone : (310) 652-8132
Second Address
- Mr. Willis H. Wagner
- 8631 W 3rd St Suite 615e
- Los Angeles, CA
- Zip : 90048-5901
- Fax : (310) 659-3815
- Phone : (310) 652-8132
Reviews
FAQs
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Is Mr. Willis H. Wagner a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0129X | Vascular Surgeon | G049464 | CA |
National Provider Identifier
| NPI | 1003836248 |
|---|---|
| Provider Name | Mr. Willis H. Wagner |
| First Address | Los Angeles, CA 90048-5901 |
| Second Address | Los Angeles, CA 90048-5901 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/07/2006 |
| Last Update Date | 08/10/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| C86940 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.