Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. PAUL BROOKS WAGNER, C.C.P.
Active Sole ProprietorMR. PAUL BROOKS WAGNER, C.C.P. is a 246XC2903X healthcare provider located in MODESTO, California. NPI 1518063916 is currently active in the NPPES registry. Verify at CMS.
246XC2903X · MODESTO, CA
Registration Details
- NPI Number
- 1518063916
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 15, 2006 (19.887525255765 yrs)
- Last Updated
- Jul 8, 2007
- License
-
890191-0970 (MS)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1836 HARBOR CVMODESTO, CA, 953551856Browse CA providers · Browse ZIP 95355
- Phone
- 2094848516
- Fax
- 2095763613
- Primary Specialty
-
246XC2903X
246XC2903X
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.