NATHAN ELI WAGNER IDC
NPI 1295355246
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Q: What is Nathan Wagner's NPI number?

The NPI number for Nathan Wagner is 1295355246. It was assigned to this individual provider in the NPPES registry on April 20, 2020.

Q: What is Nathan Wagner's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

Q: When was this NPI record last updated?

The NPPES record for Nathan Wagner was last updated on April 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 20, 2020

34800 BOB WILSON DR, SAN DIEGO, CA 92134(619) 532-6000 Get Directions Write a Review

NPPES record last updated: April 20, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Nathan Eli Wagner Idc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NATHAN ELI WAGNER IDC (NPI 1295355246) is an individual independent duty corpsman provider in San Diego, California, licensed in California (D7208222) and active in the NPI registry since April 2020.

NPPES Registry Identity

NPI1295355246

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameNATHAN ELI WAGNERCredential: IDC

Location Address34800 BOB WILSON DRSan Diego, CA 92134-1098

Mailing Address2853 Oro Blanco CirEscondido, CA 92027-5257 · (951) 733-6572

Phone(619) 532-6000

Sole ProprietorYes

Enumeration DateApril 20, 2020

NPPES CertifiedApril 20, 2020

✔ NPI 1295355246 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers

Taxonomy Code1710I1002X

License✔ Licensed in CA · D7208222

Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

34800 BOB WILSON DR, San Diego, CA 92134

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Other Providers at the Same Location NPPES 20

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