Individual provider · Type 1 NPI

Susan Katali Wagner, PA-C

Medical Physician Assistant · Riverside, CA

NPI number 1457544983 Active

Practice location

6926 Brockton Ave, Ste 9
Riverside, CA 92506-3800

Call (951) 788-0370 Map

Fax (951) 788-0390

Mailing address

26610 Kalmia Ave
Moreno Valley, CA 92555-1727

Specialties and licenses

TaxonomyCodeLicense
General Care Certified Respiratory Therapist 2278G1100XRCP19999 (CA)
Medical Physician Assistant Primary 363AM0700XPA16194 (CA)

Medical Physician Assistant: Definition to come...

9 other providers at this address

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About NPI 1457544983

Susan Katali Wagner, PA-C's National Provider Identifier is 1457544983, issued on Aug 17, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Riverside, CA. The record was last updated on Mar 7, 2023.