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PAUL D WAGNER M D INC NPI 1043383144


NPI Information

NPI: 1043383144
Provider Name: PAUL D WAGNER M D INC

Doing Business As: SAN DIEGO MEDICAL GROUP

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 05D0930584

Address:
4060 FOURTH AVE
SUITE 100
SAN DIEGO, CA
ZIP 92103
Phone: (619) 718-9444
Get Directions

PAUL D WAGNER M D INC is an internal medicine in San Diego, CA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PAUL D WAGNER M D INC NPI is 1043383144. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As San Diego Medical Group.

The provider's business location address is:

4060 FOURTH AVE
SUITE 100
SAN DIEGO, CA
ZIP 92103-120
Phone: (619) 718-9444
Fax: (619) 718-9440

The provider's authorized official is Connie Johnson .
The authorized official title is Office Mgr and has the following contact phone number (619) 718-9444.

The CLIA number assigned to this NPI record is 05D0930584 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/16/2006 and was last updated on 11/14/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineG77188CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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