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ANDREW WAGNER MD PC NPI 1639752553


NPI Information

NPI: 1639752553
Provider Name: ANDREW WAGNER MD PC
Classification: Emergency Medicine - 207P00000X
Entity Type: Organization

CLIA Number: 05D2246386

Address:
140 CENTENNIAL WAY
TUSTIN, CA
ZIP 92780
Phone: (303) 904-7240
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ANDREW WAGNER MD PC is an emergency medicine in Tustin, CA. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. ANDREW WAGNER MD PC NPI is 1639752553. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

140 CENTENNIAL WAY
TUSTIN, CA
ZIP 92780-711
Phone: (303) 904-7240

The provider's authorized official is Andrew Wagner .
The authorized official title is Owner and has the following contact phone number (303) 904-7240.

The CLIA number assigned to this NPI record is 05D2246386 - other with a certificate type of Certificate of Registration.

The enumeration date for this NPI number is 4/29/2021 and was last updated on 10/21/2021.


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
1207P00000XEmergency MedicineYes

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.