DR. GLENN NORMAN WAGNER (NPI# 1235656323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235656323 |
| Entity Type | Individual |
| Full Name | DR. GLENN NORMAN WAGNER |
| Credential | DO |
| Practice Address |
5570 Overland Ave Ste 101 San Diego CA 92123-1215 |
| Practice Telephone | (858) 694-2899 |
| Practice Fax Number | 8586942514 |
| Mailing Telephone | 8586942899 |
| Mailing Fax Number | 8586942514 |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2018-06-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 202C00000X | Independent Medical Examiner | 20A4111 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
5570 OVERLAND AVE STE 101 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-1215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104115930 | Kimi Nicole Verilhac | Pathology | 5570 Overland Ave Ste 101, San Diego, CA 92123-1215 | 2011-04-01 |
| 1720573009 | Leslie Anderson | Pathology | 5570 Overland Ave Ste 101, San Diego, CA 92123-1215 | 2018-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 202C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Independent Medical Examiner |
| A special evaluator not involved with the medical care of the individual examinee that impartially evaluates the care being provided by other practitioners to clarify clinical, disability, liability or other case issues. |
| Notes: Source: American Board of Independent Medical Examiners, www.abime.org [1/1/2007: new] |
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|---|---|---|---|---|
| 1710429105 | Medical Support Los Angeles A Medical Corporation | Independent Medical Examiner | 3405 Kenyon St, Suite #101, San Diego, CA 92110-5003 | 2016-11-16 |
| 1396941605 | Robert Bregman | Independent Medical Examiner | 34800 Bob Wilson Dr, Nmcsd, San Diego, CA 92134-1098 | 2007-06-23 |
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| 1013438811 | Medical Support Los Angeles A Medical Corporation | Independent Medical Examiner | 790 Loughborough Dr, Merced, CA 95348-2626 | 2017-06-30 |
| 1740701531 | Medical Support Los Angeles A Medical Corporation | Independent Medical Examiner | 512 Westline Dr Ste 202, Alameda, CA 94501-7605 | 2017-06-30 |
| 1154842946 | Medical Support Los Angeles A Medical Corporation | Independent Medical Examiner | 5300 Lennox Ave Ste 302, Bakersfield, CA 93309-1662 | 2017-06-30 |
| 1750802559 | Medical Support Los Angeles A Medical Corporation | Independent Medical Examiner | 1011 E Devonshire Ave Ste 200, Hemet, CA 92543-3033 | 2017-06-30 |
| 1326569112 | Medical Support Los Angeles A Medical Corporation | Independent Medical Examiner | 684 Medical Center Dr E Ste 105, Clovis, CA 93611-6806 | 2017-06-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.