Klaus Wolfgang Wagner, MD PHD

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

License

A119744 Issued in CA

Practice address

3350 La Jolla Village Dr
VA Hematology/Oncology
San Diego, CA 92161-0002

Phone

(858) 552-8585

NPI assigned

May 24, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1211587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1841458023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "address_2": "HEMATOLOGY/ONCOLOGY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-552-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "address_2": "VA HEMATOLOGY/ONCOLOGY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-552-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KLAUS",
        "middle_name": "WOLFGANG",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-24",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CA",
            "license": "A119744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207614301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A119744",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Katelyn Wagner
• Jeffrey Wagner, LPCC
• Jessica Grace Wagner, PT, DPT
• Katelin Wagner
• Kimberly Eileen Wagner, M.A.
• Megan Marie Wagner, PT, DPT
• Michele D Wagner
• Morgan Ashley Wagner
• Naomi Elizabeth Wagner, MS
• Nathan Eli Wagner, IDC

• Medical Oncology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Medical Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; 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.