Cory Wagner, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A198800 Issued in CA

Practice address

8631 W 3Rd St # 1135E
Los Angeles, CA 90048-5901

Phone

(310) 423-7494

NPI assigned

Mar 23, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1467101568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 E DEVONSHIRE AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST # 1135E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-423-7494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1117 E Devonshire Ave",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925433083",
            "country_code": "US",
            "telephone_number": "951-652-2811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "CORY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-23",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A198800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aisha Wagner, M.D.
• Alexandra E Wagner
• Alexandra Marian Wagner, LCSW
• Allen Wagner, M.A.
• Amber L Wagner
• Cynthia Ellen Wagner, LCSW
• David K. Wagner, M.D.
• James Allen Wagner, MS
• John Michael Wagner
• Justin Philip Wagner, M.D.

• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.