ROBERT LEE WAGNER JR. (NPI# 1720094055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720094055 |
| Entity Type | Individual |
| Full Name | ROBERT LEE WAGNER JR. |
| Credential | M.D. |
| Practice Address |
9850 Genesee Ave Ste 820 La Jolla CA 92037-1219 |
| Mailing Address |
File # 54433 Los Angeles CA 90074-0001 |
| Practice Telephone | 8584545442 |
| Practice Fax Number | 8584314633 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-01-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
G41244 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RAILROAD MEDICARE | P00728781 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194266734 | Robert Wagner | Contractor | 15 Misery Mountain Ln, Croydon, NH 03773-6617 | 2017-03-15 |
| 1639498553 | Robert Fredrick Wagner Jr. | Dentist | 9616 Beauclerc Bluff Rd, Jacksonville, FL 32257-5703 | 2010-05-18 |
| 1821225160 | Robert Morris Wagner | Obstetrics & Gynecology | 1004 Erie Dr, Buffalo, WY 82834-2587 | 2009-06-13 |
| 1982875852 | Robert Michael Wagner | Psychologist | 160 East Kellogg Blvd., Suite 8500, St. Paul, MN 55101 | 2008-03-18 |
| 1467673111 | Robert Wagner | Counselor | 3837 N.w. 23rd Street, Oklahoma City, OK 73112 | 2007-05-01 |
| 1558499079 | Robert Wagner | Preventive Medicine | 2850 7th St Ste 100, Berkeley, CA 94710-2703 | 2007-02-28 |
| 1679600944 | Robert Linton Wagner | Dentist | 1402 Argillite Road, Flatwoods, KY 41139 | 2007-02-27 |
| 1932253036 | Robert Eugene Wagner | Chiropractor | 10324 Canyon Rd East, #105, Puyallup, WA 98373 | 2007-01-23 |
| 1164599700 | Robert Frederick Wagner | Dentist | 2803 Ne Everett St, Portland, OR 97232-3246 | 2006-11-29 |
| 1306925243 | Robert P Wagner | Dentist | 1216 16th St W, Suite 34, Billings, MT 59102-4100 | 2006-11-02 |
| Street Address |
9850 GENESEE AVE STE 820 |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92037-1219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821640145 | Sdpm Medical Group, Incorporated | Anesthesiology | 9850 Genesee Ave Ste 820, La Jolla, CA 92037-1219 | 2019-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982221768 | Equip Health Medical, PC | Clinic/Center | 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 | 2020-06-29 |
| 1134745474 | Brenda Kay Wiederhold | Psychologist | Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 | 2020-06-23 |
| 1316581598 | Kathleen M Blechertas | Physical Therapist | 9888 Genesee, Lj19, La Jolla, CA 92037 | 2019-10-31 |
| 1316592876 | Kevin Yanyan Li | Student in an Organized Health Care Education/Training Program | 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 | 2019-08-01 |
| 1407400542 | Juan J Salmeron | Dentist | Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 | 2019-07-26 |
| 1609428598 | Nicole Whitney Mark | Physician Assistant | 8103 Caminito Sonoma, La Jolla, CA 92037 | 2019-07-11 |
| 1700357936 | Cecelia Rose Greene/pendzich | Mastectomy Fitter | 7760 Fay Ave, Suite M., La Jolla, CA 92037 | 2018-12-16 |
| 1740765890 | Jeenal Ankit Gordhandas | Student in an Organized Health Care Education/Training Program | East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 | 2018-09-25 |
| 1306325220 | Lisa Beth Perlov Marks | Marriage & Family Therapist | 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 | 2018-08-10 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| Find all providers in zip 92037 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891719233 | Gregory R Polston | Anesthesiology | 3600 Gilman Dr, Ucsd Department of Anesthesiology, La Jolla, CA 92093-0801 | 2006-07-27 |
| 1821640145 | Sdpm Medical Group, Incorporated | Anesthesiology | 9850 Genesee Ave Ste 820, La Jolla, CA 92037-1219 | 2019-07-16 |
| 1689018228 | Lars R. Newsome, M.d., Inc. | Anesthesiology | 4130 La Jolla Village Dr Ste 300, La Jolla, CA 92037-1481 | 2013-04-25 |
| 1669769980 | Joseph Shurman Md Integrative Pain Management Inc | Anesthesiology | 9834 Genesee Ave Ste 427, La Jolla, CA 92037-1264 | 2011-07-07 |
| 1205010030 | Imanuel Ruvin Lerman | Anesthesiology | 9300 Campus Point Dr, La Jolla, CA 92037-1300 | 2007-12-28 |
| 1972685949 | Wade Wong | Anesthesiology | 9300 Campus Point Dr, 7756, La Jolla, CA 92037 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912512567 | Clinicas Del Valle, Inc | Anesthesiology | 120 W. Cole Blvd, Ste. B, Calexico, CA 92231 | 2020-09-10 |
| 1609489418 | Cyrus Dadachanji Md Inc. | Anesthesiology | 34762 Midland Ave, Murrieta, CA 92563-8419 | 2020-08-31 |
| 1962050401 | Sky Anesthesia Inc. | Anesthesiology | 4477 W 118th St Ste 501, Hawthorne, CA 90250-2260 | 2019-08-28 |
| 1932671856 | North County Pain Institute | Anesthesiology | 940 E Valley Pkwy Ste K, Escondido, CA 92025-3441 | 2018-12-18 |
| 1285101824 | 16th Street Anesthesia Services Corp | Anesthesiology | 2323 16th St Ste 507, Bakersfield, CA 93301-3454 | 2018-11-01 |
| 1033697305 | Heyer Anesthesia PC | Anesthesiology | 1120 W La Veta Ave Ste 330, Orange, CA 92868-4231 | 2018-07-30 |
| 1982190229 | Algos Inc., A Medical Corporation | Anesthesiology | 12840 Riverside Dr Ste 208, Valley Village, CA 91607-3343 | 2018-07-10 |
| 1093200610 | Kevin Dinh Trinh, Md Inc. | Anesthesiology | 100 Fieldwood, Irvine, CA 92618 | 2018-06-26 |
| 1033616644 | Howard Siegel Md Inc | Anesthesiology | 8112 Milliken Ave Ste 202, Rancho Cucamonga, CA 91730-7473 | 2018-04-10 |
| 1780198952 | Unified Physician Associates Inc | Anesthesiology | 3200 S Bristol St Ste B, Santa Ana, CA 92704-6711 | 2017-11-27 |
| 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.