Robert Wagner, MD | |
11370 Anderson St, Ste 3900, Loma Linda, CA 92354-3450 | |
(909) 558-2806 | |
Not Available |
Full Name | Robert Wagner |
---|---|
Gender | Male |
Speciality | Obstetrics & Gynecology - Gynecologic Oncology |
Location | 11370 Anderson St, Loma Linda, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356363550 | NPI | - | NPPES |
00G206120 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207VX0201X | Obstetrics & Gynecology - Gynecologic Oncology | G20612 (California) | Primary |
Entity Name | Faculty Physicians And Surgeons Of Llusm |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205009917 PECOS PAC ID: 1153227814 Enrollment ID: O20031211000981 |
Mailing Address | Practice Location Address |
---|---|
Robert Wagner, MD 54701 File Number, Los Angeles, CA 90074-4701 Ph: (909) 558-3111 | Robert Wagner, MD 11370 Anderson St, Ste 3900, Loma Linda, CA 92354-3450 Ph: (909) 558-2806 |
Samira Monavvari, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 11370 Anderson St Ste 3900, Loma Linda, CA 92354 Phone: 909-558-2806 | |
Danielle C.a. Sawyer-macknet, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 25805 Barton Rd, Suite 107, Loma Linda, CA 92354 Phone: 909-478-7700 Fax: 909-478-7705 | |
Dr. Tiare Nicole Evans, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 11370 Anderson St Ste 3900, Loma Linda, CA 92354 Phone: 909-558-2806 | |
Kevin C Balli, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 11370 Anderson St, Ste 3900, Loma Linda, CA 92354 Phone: 909-558-2806 | |
Juthamas Kositsawat, Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 11370 Anderson St, Loma Linda, CA 92354 Phone: 909-558-2806 | |
Hermina Salvador, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 11370 Anderson St, Ste 3900, Loma Linda, CA 92354 Phone: 909-558-2806 | |
Ai-mae Chee Watkins, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 11370 Anderson St, Ste 3900, Loma Linda, CA 92354 Phone: 909-558-2806 |