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General NPI Number Information
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NPI Number | 1386203339
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Entity Type | Individual
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Provider Name | LINDSAY WAGGERMAN MD
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Gender | Female
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Dates
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Enumeration Date | 06/12/2019
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 300 HILLMONT AVE BLDG 340, SUITE 201
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City | VENTURA
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State | CA
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Zip | 93003-1651
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Country | US
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Telephone | 805-652-6100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 633
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City | VENTURA
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State | CA
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Zip | 93002-0633
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Country | US
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Telephone | 805-677-5181
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Fax | 805-677-5304
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M-16803
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A181004
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License Number State | CA
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