JUSTIN PHILIP WAGNER (NPI# 1871818484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871818484 |
| Entity Type | Individual |
| Full Name | JUSTIN PHILIP WAGNER |
| Credential | M.D. |
| Practice Address |
200 Ucla Medical Plz # 265 Los Angeles CA 90095-8344 |
| Mailing Address |
5767 W Century Blvd Ste 400 Los Angeles CA 90045-5631 |
| Practice Telephone | 3102062429 |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2019-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | A117746 | CA | Allopathic & Osteopathic Physicians |
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
A117746 | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 27235 Tourney Rd Ste 2500, Santa Clarita, CA 913555908 | 3102062429 | 3102061120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669451472 | Justin Roman Wagner | Specialist | Rec Center Physical Therapy, 400 Collins Rd Ne 154-100, Cedar Rapids, IA 52498-0001 | 2006-01-10 |
| 1871121798 | Justin John Wagner | Student in an Organized Health Care Education/Training Program | 2601 Ocean Pkwy, Brooklyn, NY 11235-7745 | 2020-03-27 |
| 1245647700 | Justin Wagner | Pharmacist | 1650 W Maloney Ave, Gallup, NM 87301-3305 | 2014-07-16 |
| 1356608004 | Justin Timothy Wagner | Radiology | 804 Service Rd, Room D100, East Lansing, MI 48824-7021 | 2012-04-19 |
| 1306051362 | Justin B Wagner | Emergency Medicine | 1650 Creekside Dr, Folsom, CA 95630-3400 | 2007-05-13 |
| Street Address |
200 UCLA MEDICAL PLZ # 265 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90095-8344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982212155 | Alexandra Gubin | Social Worker | Ucla, 757 Westwood Medical Plaza, Los Angeles, CA 90095 | 2020-07-14 |
| 1952926263 | Georgina Parra | Student in an Organized Health Care Education/Training Program | 10833 Le Conteave, Los Angeles, CA 90095 | 2020-06-11 |
| 1609403575 | Yagmur Muftuoglu | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Neurosurgery, Los Angeles, CA 90095 | 2020-03-23 |
| 1619438173 | Brandon Covington Smith | Student in an Organized Health Care Education/Training Program | 727 Westwood Plaza, Dept of Internal Medicine, Los Angeles, CA 90095 | 2019-03-27 |
| 1184184913 | Alexander Daniel Yuen | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza (internal Medicine), Los Angeles, CA 90095 | 2019-03-19 |
| 1790266369 | Dana Saifan | Student in an Organized Health Care Education/Training Program | 1000 Veteran Avenue, Los Angeles, CA 90095 | 2018-08-22 |
| 1427549146 | Courtney Renee' Real | Registered Nurse | 757 Westwood Plz Ste 6236, Los Angeles, CA 90095 | 2018-05-29 |
| 1932605094 | Akash Atul Shah | Student in an Organized Health Care Education/Training Program | Ucla Department of Orthopaedic Surgery, 10833 Le Conte Avenue, 76-116 Chs, Los Angeles, CA 90095 | 2018-04-05 |
| 1316443435 | Dane Jensen Brodke | Orthopaedic Surgery | 757 Westwood Plaza, (orthopaedic Surgery), Los Angeles, CA 90095 | 2018-04-05 |
| 1477058824 | Thomas William Gaither Castellanos | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Urology, Los Angeles, CA 90095 | 2018-03-28 |
| Find all providers in zip 90095 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295053437 | Ashley Walther | Surgery | 4650 W Sunset Blvd # Ms 100, Los Angeles, CA 90027 | 2010-05-12 |
| 1124203872 | Children's Hospital Los Angeles Medical Group | Surgery | 4650 W Sunset Blvd # 72, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1982135794 | Jordan Wlodarczyk | Surgery | 1200 N State St, Clinic Tower, Suite A7d, Los Angeles, CA 90033-1029 | 2017-03-23 |
| 1215224068 | David Darcy | Surgery | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2011-06-30 |
| 1790010221 | Eveline Shue | Surgery | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2009-10-16 |
| 1598998999 | Lorraine I. Kelley-quon | Surgery | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2009-09-01 |
| 1316110521 | Stanley Taune Lau | Surgery | 4760 W Sunset Blvd, 3rd Floor, Los Angeles, CA 90027-6063 | 2008-04-08 |
| 1982739058 | Manuel B. Torres | Surgery | 4650 W Sunset Blvd, Ms#72, Los Angeles, CA 90027-6062 | 2007-02-22 |
| 1346317369 | George E. Wilkinson Jr. | Surgery | 6041 Cadillac Ave, Los Angeles, CA 90034-1702 | 2006-11-29 |
| 1467523340 | Steven Leung Lee | Surgery | 4733 W Sunset Blvd, Los Angeles, CA 90027-6021 | 2006-11-13 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90095 |
Please comment or provide details below to improve the information on JUSTIN PHILIP WAGNER.
| 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.