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1306888995
KENDALL SHANNON WAGNER
FULLERTON, CA
NPI
1306888995
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
(Licence: CA G40943)
Enumeration Date
2006-06-11
Last Update Date
2010-08-05
Business Address
-- KENDALL SHANNON WAGNER M.D.
101 LAGUNA RD STE A
FULLERTON, CA 92835-3635
Phone number: 714-879-0050
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Mailing Address
-- KENDALL SHANNON WAGNER M.D.
101 LAGUNA RD STE A
FULLERTON, CA 92835-3635
Phone number: 714-879-0050
Copy
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