Nathan Eli Wagner, IDC
Nathan Eli Wagner, IDC is an Independent Duty Corpsman in San Diego, California. Practices as a sole proprietor. Licensed in California.
- Licensed in
- CA
- In the registry since
- 2020
Practice location Address checks out
34800 Bob Wilson DrSan Diego, CA 92134-1098
Phone: (619) 532-6000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Independent Duty Corpsman (primary) | Taxonomy 1710I1002X · Licence D7208222 (CA) |
|---|
Record details
| NPI number | 1295355246 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | IDC |
| Sole proprietor | Yes |
| NPI enumerated | April 20, 2020 |
| Last updated in NPPES | April 20, 2020 |
| Certification date | April 20, 2020 |
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