Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GENESA WAGONER, M.D.
ActiveGENESA WAGONER, M.D. is a Pediatrics healthcare provider located in SAN PEDRO, California. NPI 1518074160 is currently active in the NPPES registry. Verify at CMS.
Pediatrics · SAN PEDRO, CA
Registration Details
- NPI Number
- 1518074160
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 23, 2006 (19.947687200113 yrs)
- Last Updated
- Dec 2, 2011
- License
-
G77273 (CA)
Practice Information
- Address
-
1294 W 6TH STSUITE 104SAN PEDRO, CA, 907312987Browse CA providers · Browse ZIP 90731
- Phone
- 3105489118
- Fax
- 3105481310
- Primary Specialty
-
Pediatrics
208000000X
Other Pediatrics Providers in SAN PEDRO, CA
| Name | Credential | NPI |
|---|---|---|
| JULIE CHOW LIN | M.D. | 1912014481 |
| MICHAEL CULMER | M.D. | 1336256973 |
| CAROLYN DANA CZAPLICKI | D.O. | 1902995236 |
| SHAMS YOONESSI, M.D | M.D. | 1144370354 |
| DR. HANAA N HANNA | M.D. | 1003954942 |
| DR. PARVANEH DELBAKHSH | M.D. | 1891908869 |
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.