Organization Active NPI

Amelie Wagner, M.D.

Doing business as Ally Clinics Medical Practice

  • Family Medicine Physician
  • Murrieta, CA
National Provider Identifier
1912772336
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AMELIE WAGNER, M.D.
Doing business as
Ally Clinics Medical Practice
Practice address
40700 California Oaks Rd Ste 208
Murrieta, CA 92562-5789
Phone
(888) 858-2002
NPI assigned
Nov 15, 2023
Last updated
Mar 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Authorized official

Name
Amelie Corinne Wagner, MDNPI 1538823760
Title
Chief Executive Officer
Phone
(408) 757-0730

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

40700 California Oaks Rd Ste 208
Murrieta, CA 92562-5789

Mailing address

40960 California Oaks Rd # 1061
Murrieta, CA 92562-5747

Other names 1

  • ALLY CLINICS MEDICAL PRACTICE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241227000297 CA Part B Supplier - Clinic/Group Practice 7810424181 Receives reassigned benefits from 3 practitioners
Practice locations: Murrieta, CA

National Provider Directory

National Provider Directory

Locations

500 E Hamilton Ave
Campbell, CA 95008
Phone (415) 894-2073

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741824000000",
    "number": "1912772336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40960 CALIFORNIA OAKS RD # 1061",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40700 CALIFORNIA OAKS RD STE 208",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625789",
            "telephone_number": "888-858-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMELIE WAGNER, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-15",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "AMELIE",
        "authorized_official_middle_name": "CORINNE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "408-757-0730",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALLY CLINICS MEDICAL PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.