IndividualActive
Glenn Wagner, DO
NPI 1235656323 · Independent Medical Examiner Physician · San Diego, CA
Provider details
- NPI number
- 1235656323
- Entity type
- Individual
- Primary specialty
- Independent Medical Examiner PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- Yes
- License
- 20A4111 (CA)
Practice location
5570 Overland Ave Ste 101
San Diego, CA 92123-1215
Phone: (858) 694-2899
Fax: (858) 694-2514
Mailing address
5570 Overland Ave Ste 101
San Diego, CA 92123-1215
Registry dates
- Enumerated
- 2017-08-29
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.