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Kendall Shannon Wagner, MD
Specialist in Fullerton, California
NPI 1306888995

Kendall Shannon Wagner is a Specialist based in Fullerton, CA. Kendall Shannon Wagner practices in Fullerton, CA and has the professional credentials of MD. The NPI Number for Kendall Shannon Wagner is 1306888995 and holds a License No. G40943 (California).

The current practice location address for Kendall Shannon Wagner is 101 Laguna Rd Ste A, Fullerton, CA and can be reached out via phone at 714-879-0050 and via fax at 714-879-0249.

Location: 101 Laguna Rd Ste A, Fullerton, CA, 92835-3635
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1306888995
Provider Name
Kendall Shannon Wagner
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
101 Laguna Rd Ste A, Fullerton, CA, 92835-3635
Phone Number
714-879-0050
Fax Number
714-879-0249
Provider Enumeration Date
06/11/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
101 Laguna Rd Ste A
City
Fullerton
State
California
Zip
92835-3635
Phone Number
714-879-0050
Fax Number
714-879-0249
person
Provider Business Mailing Address Details
Address
101 Laguna Rd Ste A
City
Fullerton
State
California
Zip
92835-3635
Phone Number
714-879-0050
Fax Number
714-879-0249
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
G40943 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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