GENESA WAGONER

SAN PEDRO, CA
NPI1518074160
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: CA  G77273)
Enumeration Date2006-08-23
Last Update Date2011-12-02
Business Address
-- GENESA WAGONER M.D.
1294 W 6TH ST SUITE 104
SAN PEDRO, CA 90731-2987
Phone number: 310-548-9118
Mailing Address
-- GENESA WAGONER M.D.
1294 W 6TH ST SUITE 104
SAN PEDRO, CA 90731-2987
Phone number: 310-548-9118
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