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KENDALL SHANNON WAGNER M.D.
NPI 1306888995
Specialist in Fullerton, CA

Active since June 11, 2006
101 LAGUNA RD STE A, FULLERTON, CA 92835(714) 879-0050(714) 879-0249 Get Directions Write a Review

NPPES record last updated: August 5, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kendall Shannon Wagner M.d. NPPES

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

KENDALL SHANNON WAGNER M.D. (NPI 1306888995) is an individual specialist in Fullerton, California, licensed in California (G40943) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1306888995
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameKENDALL SHANNON WAGNERCredential: M.D.
Location Address101 LAGUNA RD STE AFullerton, CA 92835-3635
Mailing Address101 Laguna Rd Ste AFullerton, CA 92835-3635 · (714) 879-0050 · Fax (714) 879-0249
Phone(714) 879-0050
Fax(714) 879-0249
Sole ProprietorNo
Enumeration DateJune 11, 2006
Last NPPES UpdateAugust 5, 2010
✔ NPI 1306888995 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CA · G40943
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
101 LAGUNA RD STE A, Fullerton, CA 92835
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Other Identifiers 1

Medicare UPINA48404CA

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kendall Wagner's NPI number?

The NPI number for Kendall Wagner is 1306888995. It was assigned to this individual provider in the NPPES registry on June 11, 2006.

Where is Kendall Wagner located?

Kendall Wagner practices at 101 Laguna Rd Ste A, Fullerton, CA 92835. The listed phone number is (714) 879-0050.

What is Kendall Wagner's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Kendall Wagner was last updated on August 5, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.