Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Paul Brooks Wagner, CCP

Individual provider Vascular Specialist/Technologist Cardiovascular · NPI 1518063916

Mr. Paul Brooks Wagner, CCP is a Vascular Specialist/Technologist Cardiovascular in Modesto, California. Practices as a sole proprietor. Licensed in Mississippi.

Licensed in
MS
In the registry since
2006

Practice location Address checks out

1836 Harbor Cv
Modesto, CA 95355-1856
Phone: (209) 484-8516
Fax: (209) 576-3613
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular Specialist/Technologist Cardiovascular (primary) Taxonomy 246XC2903X · Licence 890191-0970 (MS)

Record details

NPI number1518063916
Entity typeIndividual (Type 1)
GenderMale
Credentials CCP
Sole proprietorYes
NPI enumeratedSeptember 15, 2006
Last updated in NPPESJuly 8, 2007