MEDICARE: MR. ALLEN WAGNER M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC45448	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740311372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALLEN WAGNER M.A.

Provider Business Mailing Address
First Line	:	5757 WILSHIRE BLVD STE 635
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-3686
Country	:	US
Telephone Number	:	310-429-5310
Fax Number	:	323-931-6027

Provider Business Practice Location Address
First Line	:	5757 WILSHIRE BLVD STE 635
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-3686
Country	:	US
Telephone Number	:	310-429-5310
Fax Number	:	323-931-6027

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	09/22/2016

Similar Medicare Providers

1861429102 — FAIRFAX MRI CENTER
Practice Location Address:

5757 WILSHIRE BLVD STE 100
LOS ANGELES, CA
90036-3686

Practice Phone: 323-648-0500
Practice Fax: 323-648-0508

1184745200 — WENDY MONROY
Practice Location Address:

5757 WILSHIRE BLVD STE 635
LOS ANGELES, CA
90036-3686

Practice Phone: 323-931-6025
Practice Fax:

1316105372 — UNIVERSAL MRI & CT INC
Practice Location Address:

5757 WILSHIRE BLVD STE 100
LOS ANGELES, CA
90036-3686

Practice Phone: 310-407-5440
Practice Fax: 310-407-5441

1811342439 — CALIFORNIA MEDICAL IMAGING CORP.
Practice Location Address:

5757 WILSHIRE BLVD STE 100
LOS ANGELES, CA
90036-3686

Practice Phone: 323-648-0500
Practice Fax: 323-648-0508

1700394764 — MR. JOHN JAMES RILEY LCSW
Practice Location Address:

5757 WILSHIRE BLVD STE 635
LOS ANGELES, CA
90036-3686

Practice Phone: 323-791-4107
Practice Fax:

1457985426 — CARE PRESCRIPTION MANAGEMENT
Practice Location Address:

5757 WILSHIRE BLVD STE 320
LOS ANGELES, CA
90036-3686

Practice Phone: 310-935-1899
Practice Fax: 310-691-1731

Directions to “ MR. ALLEN WAGNER M.A.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.