Brian Wagoner

Primary specialty

SpecialistTaxonomy code 174400000X

License

L9626

Practice address

Dana Elise Solutions, LLC.
450 North Bedford Drive, Suite 200
Beverly Hills, CA 90210

Phone

(310) 550-5566

Fax

(310) 861-1164

NPI assigned

Apr 26, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dana Elise Solutions

  • Specialist
  • Beverly Hills, CA
  • NPI 1902256712
  NPD (past)

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1952099061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 NORTH BEDFORD DRIVE",
            "address_2": "SUITE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90210",
            "telephone_number": "714-580-9186",
            "fax_number": "310-861-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DANA ELISE SOLUTIONS, LLC.",
            "address_2": "450 NORTH BEDFORD DRIVE, SUITE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90210",
            "telephone_number": "310-550-5566",
            "fax_number": "310-861-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "BRIAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": "L9626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shira Rhonda Wacholder-Siegal, O.T.R.
• Umarin Wachter, CMT
• Sumeet Haresh Wadhwani, M.D.
• Stacy Monique Wadlington, PH.D.
• Elliott Jay Wagner, M.D.
• Katherine Walczuk, MA, OTR/L
• Alexander Waldman, DMD, MMSC
• Cory Adam Waldman, M.D.
• Lisa Waldman, L.C. S. W., M.P.H.
• Wendy Kim Waldman, M.D.

• Specialist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.