Robert G. Wagner
Oral & Maxillofacial Surgeon
280 W Macarthur Blvd
Oakland
, California 94611-5642
Robert G. Wagner
Oral & Maxillofacial Surgeon
280 W Macarthur Blvd
Oakland
, California 94611-5642
(510) 625-6262
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About
Features
Specialties
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Robert G. Wagner
- 1800 Harrison St Fl 7
- Oakland, CA
- Zip : 94612-3429
- Phone : (510) 625-6262
Second Address
- Robert G. Wagner
- 280 W Macarthur Blvd
- Oakland, CA
- Zip : 94611-5642
- Phone : (510) 752-1000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgeon | A87568 | CA |
National Provider Identifier
| NPI | 1558435149 |
|---|---|
| Provider Name | Robert G. Wagner |
| First Address | Oakland, CA 94612-3429 |
| Second Address | Oakland, CA 94611-5642 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/11/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| U92419 | (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.