Genesa Wagoner, M.D.
NPI #1518074160 in San Pedro, California
Provider Information
- NPI Number
- 1518074160
- Entity Type
- Individual
- Name
- Genesa Wagoner, M.D.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Pediatrics
- Credential
- M.D.
- Enumeration Date
- Aug 23, 2006
- Last Updated
- Dec 2, 2011
Practice Location
- Address
- 1294 W 6TH ST
- Address 2
- SUITE 104
- City
- San Pedro
- State
- California
- ZIP Code
- 90731-2987
- Phone
- (310) 548-9118
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics |
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