Leonard Robert Wagner, DPM Valid NPI

Individual provider · Podiatrist · Sherman Oaks, CA

NPI

1194888255

Type

Individual (Type 1)

Primary specialty

Podiatrist

Specialty group

Podiatric Medicine & Surgery Service Providers

Taxonomy code

213E00000X

License number

E1949 (CA)

Sex

Male

Sole proprietor

Yes

Enumerated

2006-12-19

Last updated

2012-04-04