NATHAN ELI WAGNER

SAN DIEGO, CA
NPI1295355246
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
(Licence: CA  D7208222)
Enumeration Date2020-04-20
Last Update Date2020-04-20
Business Address
NATHAN ELI WAGNER IDC
34800 BOB WILSON DR
SAN DIEGO, CA 92134-1098
Phone number: 619-532-6000
Mailing Address
NATHAN ELI WAGNER IDC
2853 ORO BLANCO CIR
ESCONDIDO, CA 92027-5257
Phone number: 951-733-6572