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General NPI Number Information
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NPI Number | 1588647481
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Entity Type | Individual
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Provider Name | ROBERT L. WAGUESPACK M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 03/12/2013
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Provider Practice Location Address
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Address Line | 3550 Q ST STE 302
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City | BAKERSFIELD
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State | CA
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Zip | 93301-1645
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Country | US
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Telephone | 661-331-3303
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Fax | 661-321-3308
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Provider Business Mailing Address
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Address Line | PO BOX 406
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City | BAKERSFIELD
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State | CA
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Zip | 93302-0406
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Country | US
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Telephone | 661-331-3303
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Fax | 661-321-3308
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | G84995
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License Number State | CA
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