MR. PAUL BROOKS WAGNER (NPI# 1518063916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518063916 |
| Entity Type | Individual |
| Full Name | MR. PAUL BROOKS WAGNER |
| Credential | C.C.P. |
| Practice Address |
1836 Harbor Cv Modesto CA 95355-1856 |
| Practice Telephone | 2094848516 |
| Practice Fax Number | 2095763613 |
| Mailing Telephone | 2094848516 |
| Mailing Fax Number | 2095763613 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246XC2903X |
Spec/Tech, Cardiovascular Specialization: Vascular Specialist |
890191-0970 | MS | Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609932888 | Paul Wagner | Optometrist | 2955 W. Elliot Rd., Suite 1, Chandler, AZ 85224 | 2006-12-29 |
| 1518069491 | Paul Francis Wagner | Ophthalmology | 308 Mchenry St, Burlington, WI 53105 | 2006-09-02 |
| 1942766787 | Paul Wagner | Counselor | 26 Mount Zion Rd, York, PA 17402-2601 | 2019-02-18 |
| 1962434043 | Paul A Wagner | Family Medicine | 611 East Main St, Hart, MI 49420-1190 | 2006-07-07 |
| 1518901990 | Paul D Wagner | Internal Medicine | 3200 Maccorkle Avenue Se, Hospitalists Program, Charleston, WV 25304 | 2006-06-15 |
| 1023093663 | Paul D Wagner | Internal Medicine | 4060 4th Ave, Suite 100, San Diego, CA 92103-2116 | 2005-12-07 |
| Street Address |
1836 HARBOR CV |
| City | MODESTO |
| State | CA |
| Zip Code | 95355-1856 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982211793 | I To I LLC | Optometrist | 3401 Oakdale Rd, Ste 525, Modesto, CA 95355 | 2020-09-25 |
| 1205443116 | Altwal and Shelat Dds Inc | Dentist | 1317 Oakdale Road, Suite 310, Modesto, CA 95355 | 2020-09-24 |
| 1184255911 | Reeves, D.d.s. and Lavalley, D.d.s., A Dental Corporation | Clinic/Center | 3401 Oakdale Road, Suite 505, Modesto, CA 95355 | 2020-01-30 |
| 1487133856 | Natalie Vargas | Behavior Technician | 1317 Oakdale Road Suite 610, Modesto, CA 95355 | 2018-08-07 |
| 1871079152 | Jill H Fusia | Dietitian, Registered | 1404 Cordero Court, Modesto, CA 95355 | 2018-07-19 |
| 1043727514 | Emily Lauren Schaefer | Behavioral Analyst | 3425 Coffee Rd Ste C2, Modesto, CA 95355 | 2018-01-05 |
| 1376083691 | Hari Gnanasekeram, PC | Technician, Cardiology | 1303 Mable Avenu, Modesto, CA 95355 | 2017-03-06 |
| 1598139891 | Encompass Health Rehabilitation Hospital of Modesto, LLC | Rehabilitation Hospital | 1303 Mable Avenue, Modesto, CA 95355 | 2015-11-24 |
| 1013387844 | Diana Faith Kigenyi | Social Worker | 1225 Oakdale Road, Modesto, CA 95355 | 2015-10-06 |
| 1437530672 | Tzu Yi Wei | Acupuncturist | 2209 Coffee Road, Suite A, Modesto, CA 95355 | 2015-06-12 |
| Find all providers in zip 95355 | ||||
| Taxonomy Code | 246XC2903X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Spec/Tech, Cardiovascular |
| Specialization | Vascular Specialist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548811037 | Tayler Suzanne Kopperud | Spec/Tech, Cardiovascular | 4959 Palo Verde St Ste 208c-4, Montclair, CA 91763-2360 | 2019-09-25 |
| 1821468505 | Sally Botrus | Spec/Tech, Cardiovascular | 41054 Rawling Ct, Indio, CA 92203-4024 | 2015-10-07 |
| 1255738241 | Southern California Picc Providers, Inc. | Spec/Tech, Cardiovascular | 5787 Little Shay Dr, Fontana, CA 92336 | 2014-11-19 |
| 1932512720 | Davier Davon Mayes | Spec/Tech, Cardiovascular | 2334 10th St, Unit 1, Berkeley, CA 94710-2355 | 2014-06-09 |
| 1841568748 | Hector Solis | Spec/Tech, Cardiovascular | 2302 E Ward Ter, Anaheim, CA 92806-3657 | 2011-12-06 |
| 1053693135 | Cypress Point Healthcare Solutions, Inc | Spec/Tech, Cardiovascular | Cypress Diagnostic Imaging, 3230 Waring Ct Ste I, Oceanside, CA 92056-4509 | 2011-09-14 |
| 1437330107 | William Charles Huerta | Spec/Tech, Cardiovascular | 23135 Market St, Santa Clarita, CA 91321-3611 | 2007-11-21 |
| 1184842429 | Donald Andrew Barkley | Spec/Tech, Cardiovascular | 3534 Santa Carlotta St, Glendale, CA 91214-1115 | 2007-04-23 |
| 1568547099 | John Rosental | Spec/Tech, Cardiovascular | 1040 Elm Ave Ste 303, Long Beach, CA 90813-3267 | 2006-10-25 |
| 1285731307 | Cardiovascular Perfusion Systems | Spec/Tech, Cardiovascular | 1330 Corte De Primavera, Thousand Oaks, CA 91360-7026 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.