Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. IRVEN ROBERT WAGNER, O.D.
Active Sole ProprietorDR. IRVEN ROBERT WAGNER, O.D. is a Vision Therapy Optometrist healthcare provider located in SANTA ROSA, California. NPI 1376687814 is currently active in the NPPES registry. Verify at CMS.
Vision Therapy Optometrist · SANTA ROSA, CA
Registration Details
- NPI Number
- 1376687814
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 17, 2007 (19.518999016617 yrs)
- Last Updated
- Apr 22, 2009
- License
-
8372TPA (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
800 CODDINGTOWN CTRSANTA ROSA, CA, 954013511Browse CA providers · Browse ZIP 95401
- Phone
- 7075261881
- Fax
- 7075422014
- Primary Specialty
-
Vision Therapy Optometrist
152WV0400X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.