| Genesa Wagoner, MD | |
|
1294 W 6th St, Suite 104, San Pedro, CA 90731-2987 | |
| (310) 548-9118 | |
| (310) 548-1310 |
| Full Name | Genesa Wagoner |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 1294 W 6th St, San Pedro, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518074160 | NPI | - | NPPES |
| 00G772730 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | G77273 (California) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Genesa Wagoner, MD 1294 W 6th St, Suite 104, San Pedro, CA 90731-2987 Ph: (310) 548-9118 | Genesa Wagoner, MD 1294 W 6th St, Suite 104, San Pedro, CA 90731-2987 Ph: (310) 548-9118 |
Shams Yoonessi, M.d, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 731 S Beacon St, San Pedro, CA 90731 Phone: 310-732-5889 Fax: 310-732-5890 | |
Mr. Kenneth Earl Follmar Iii, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1294 W 6th St Ste 102, San Pedro, CA 90731 Phone: 310-944-1108 | |
Michael Culmer, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1294 W 6th St, Suite 104, San Pedro, CA 90731 Phone: 321-054-8911 Fax: 310-548-1310 | |
Lori Rochelle Krieger, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1360 W 6th St, Suite 300, San Pedro, CA 90732 Phone: 310-514-0838 Fax: 310-514-0425 | |
Dr. Pitchaya Pam Chitamitara, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1294 W 6th St Ste 104, San Pedro, CA 90731 Phone: 310-548-9118 | |
Dr. Parvaneh Delbakhsh, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 731 S Beacon St, San Pedro, CA 90731 Phone: 310-732-5887 Fax: 310-732-5890 |