Board-certified in internal medicine with a subspecialty in hospice and palliative medicine, Paul D. Wagner, MD, FACP practices primary care at San Diego Medical Group inside the 4060 Fourth Ave medical office building, an independent practice that joined the UC San Diego Health Physician Network. Chronic disease panels for diabetes, hypertension, high cholesterol, and thyroid disorders frequently coordinate imaging and surgical consults with Surgical Specialists Of San Diego when a scan or palpable finding calls for operative review. Dr. Wagner earned his MD from UC San Diego School of Medicine in 1992 and completed his internal medicine residency at Scripps Mercy Hospital from 1992 to 1995, giving the practice a layered view of the same Hillcrest hospital corridor its patients pass through. Before medicine he spent six years earning a Bachelor of Arts and a Master of Arts in seminary, and the practice carries an American Academy of Hospice and Palliative Medicine fellowship into end-of-life planning conversations that most primary care offices hand off. Musculoskeletal complaints that surface during annual physicals route to rehab partners including Spine & Sport Physical Therapy - Hillcrest, 5th Ave., keeping the treatment arc local for post-surgical shoulders and chronic low-back cases. The most complex visits here braid diabetes control, heart failure, and advance care planning into one appointment - the triple-problem follow-up that defines internal medicine in an aging Hillcrest panel.