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Search › California › 208000000X

Genesa Wagoner, M.D

NPI 1518074160 · on the registry since 2006

Practice

Address
1294 W 6th St
Suite 104
San Pedro, CA 90731
Phone
(310) 548-9118
Fax
(310) 548-1310
Organisation at this address
Peninsula Pharmacy
Kimberly R Walton Md Inc
San Pedro Pediatrics Med Grp Inc
Borrowed Star Psychology Group, Inc
Harbor Physical Therapy & Sports Medical
Inferred from a shared address, not stated in the registry.
Clinicians at this address
40

Registry record

Primary taxonomy
208000000X
208000000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2011-12-02

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California