Ernest a Bagner III MD Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

W19781 Issued in CA

Legal business name

ERNEST A BAGNER III MD INC

Practice address

541 W Colorado St
207
Glendale, CA 91204-3638

Phone

(818) 291-9827

Fax

(818) 291-9822

NPI assigned

Jul 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ernest A Bagner III, M.D.

Title

President

Phone

(818) 291-9827

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497776314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 W COLORADO ST",
            "address_2": "207",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043638",
            "telephone_number": "818-291-9827",
            "fax_number": "818-291-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 W COLORADO ST",
            "address_2": "207",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043638",
            "telephone_number": "818-291-9827",
            "fax_number": "818-291-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERNEST A BAGNER III MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAGNER",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-291-9827",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "W19781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sebastian Erdman-Waterhouse
• Mona S.P Eremita, M.D
• Larry Ereshefsky, PHARM.D.
• Eric Greene, PHD
• Arlene L Ermshar, BSRDH
• Paul V Erwin Jr., DDS, MS
• Daniel Escobar
• Edward Philip Deguzman Escobar, PTA
• Jade Escobar
• Giovanni Escorcia

• All providers in Glendale, CA
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.