Bruce Wagner, OD

NPI #1053434035 in Monarch Beach, California

Provider Information

NPI Number: 1053434035
Entity Type: Individual
Name: Bruce Wagner, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Apr 6, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 24040 CAMINO DEL AVION STE E
City: Monarch Beach
State: California
ZIP Code: 92629-4005
Phone: (949) 443-9110

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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