Gary Wagner is a Dermatology in Modesto, California. Gary Wagner practices all healthcare services and medical treatments related to Dermatology. The NPI Number for Gary Wagner is 1235160102. The last update date is 2016-04-01.
Gary Wagner's current location address is 600 Coffee Rd, Modesto, California. You can contact this provider via phone number 2095241211. The mailing address for Gary Wagner is 600 Coffee Rd, Modesto, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gary Wagner |
|---|---|
| Address | 600 Coffee Rd, Modesto, California |
| Phone Number | 2095241211 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1235160102 |
|---|---|
| Provider Enumeration Date | 2006-07-06 |
| Last Updated Date | 2016-04-01 |
Provider Mailing Address Detail
| Address | 600 Coffee Rd |
|---|---|
| City | Modesto |
| State | California (CA) |
| Post Code | 953554201 |
| Phone Number | 2095241211 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dermatology |
|---|---|
| Taxonomy | 207N00000X |
| Licence No | A24987 |
|
Definition: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00A249871 | CA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Gary Wagner by the Centers for Medicare & Medicaid Services (CMS)?
The Gary Wagner has been assigned the NPI (National Provider Identifier) 1235160102. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical address where Gary Wagner is geographically located?
The Gary Wagner is physically situated at the following location: 600 Coffee Rd, Modesto, CA, 953554201.
What is Gary Wagner's specialized field of practice, and what is the corresponding taxonomy classification code?
The Gary Wagner's area of specialization is Dermatology, and the corresponding taxonomy code that categorizes this field of practice is 207N00000X.
On what date did the Gary Wagner receive its 1235160102 assignment from the Centers for Medicare & Medicaid Services?
The Gary Wagner was assigned its 1235160102 by the Centers for Medicare & Medicaid Services on 2006-07-06.
As of what date were the Gary Wagner's details last updated?
The information pertaining to the Gary Wagner, including its address, specialty, and other details, was most recently updated on 2016-04-01.
NPI Number: 1902809924
Address: 2400 W Main St, Rock Hill, SC
NPI Number: 1245233493
Address: 108 W Market St, Bloomington, IL