Healthcare Provider Details

I. General information

NPI: 1710041413
Provider Name (Legal Business Name): RICHARD WAGNER GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 N BELLFLOWER BLVD
LONG BEACH CA
90815-3126
US

IV. Provider business mailing address

2100 N BELLFLOWER BLVD
LONG BEACH CA
90815-3126
US

V. Phone/Fax

Practice location:
  • Phone: 562-596-0889
  • Fax: 562-596-9479
Mailing address:
  • Phone: 562-596-0889
  • Fax: 562-596-9479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. RICHARD WAGNER
Title or Position: PRESIDENT
Credential:
Phone: 562-986-0889