NPI 1003836248

Willis H. Wagner, MD

Practitioner Vascular Surgery Physician Los Angeles, CA

Practice location

Address: 8631 W 3rd St Suite 615e, Los Angeles, CA 90048-5901
Phone: (310) 652-8132
Fax: (310) 659-3815

Registered specialties

Vascular Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2086S0129X Licence G049464 (CA)

Other Surgery providers in California →

Registry record

NPI: 1003836248
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Jul 2006
Record last updated: 8 Oct 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.