Organization Active NPI

Leonard R Wagner DPM a Professional Corporation

  • Podiatrist
  • Sherman Oaks, CA
National Provider Identifier
1487959037
Registry record updated Jan 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
LEONARD R WAGNER DPM A PROFESSIONAL CORPORATION
Practice address
4955 Van Nuys Blvd
Suite 107
Sherman Oaks, CA 91403-1801
Phone
(818) 995-8228
Fax
(818) 995-1539
NPI assigned
Jan 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2011

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

Authorized official

Name
Dr. Leonard R Wagner, DPM
Title
President
Phone
(818) 995-8228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

4955 Van Nuys Blvd
Suite 107
Sherman Oaks, CA 91403-1801

Mailing address

4955 Van Nuys Blvd
Suite 107
Sherman Oaks, CA 91403-1801
Phone (818) 995-8228

National Provider Directory

National Provider Directory

Locations

4955 Van Nuys Blvd
Ste 107
Sherman Oaks, CA 91403
Phone (818) 995-8228

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1487959037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD",
            "address_2": "SUITE 107",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031801",
            "telephone_number": "818-995-8228",
            "fax_number": "818-995-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD",
            "address_2": "SUITE 107",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031801",
            "telephone_number": "818-995-8228",
            "fax_number": "818-995-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEONARD R WAGNER DPM A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-995-8228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; 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.