SDPM Medical Group, Incorporated

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

SDPM MEDICAL GROUP, INCORPORATED

Practice address

9850 Genesee Ave Ste 820
La Jolla, CA 92037-1219

Phone

(858) 454-5442

Fax

(858) 431-4633

NPI assigned

Jul 16, 2019

Organization subpart

No

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

Authorized official

Name

Robert Lee Wagner Jr., MD

Title

President

Phone

(858) 454-5442

Specialties & licenses 1

Addresses

Other names 1

• San Diego Pain Management Doing business as

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1821640145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221048",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921921048",
            "telephone_number": "858-395-0309",
            "fax_number": "858-452-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE STE 820",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371219",
            "telephone_number": "858-454-5442",
            "fax_number": "858-431-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SDPM MEDICAL GROUP, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-16",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-454-5442",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Diego Pain Management",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "San Diego Pain Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• SD Psychology, a Professional Corporation
• Stephen L. Seagren, M.D.
• Laurel Seaholm, L.AC., DIPL. O.M.
• Mary Susan Seaman, NP
• Sean Ryan, M.D., a Professional Corporation
• Sarah Dawn Searle, RN, CCE, RPYT

• Pain Medicine (Anesthesiology) Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Pain Medicine (Anesthesiology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.