Lisa a. Wagner Chiropractic, Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

DC23398 Issued in CA

Legal business name

LISA A. WAGNER CHIROPRACTIC, INC

Practice address

625 E Arrow Hwy
Suite 2
Glendora, CA 91740-6521

Phone

(626) 852-2822

Fax

(626) 852-2824

NPI assigned

Mar 9, 2011

Last updated

Mar 9, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lisa Ann Wagner, DCNPI 1942398706

Title

Sole Owner

Phone

(626) 852-2822

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Ann Wagner, D.C.

  • Chiropractor
  • Glendora, CA
  • NPI 1942398706
  Authorized official Same address or phone

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299628800000",
    "number": "1750689196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E ARROW HWY",
            "address_2": "SUITE 2",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917406521",
            "telephone_number": "626-852-2822",
            "fax_number": "626-852-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E ARROW HWY",
            "address_2": "SUITE 2",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917406521",
            "telephone_number": "626-852-2822",
            "fax_number": "626-852-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA A. WAGNER CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-09",
        "last_updated": "2011-03-09",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "626-852-2822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "DC23398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Glendora, CA
• Providers in Glendora, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.