MEDICARE: DR. ROBERT MITCHEL WOLFF D.C.,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC22895	CA

General Provider Information

NPI Number	:	1063515922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT MITCHEL WOLFF D.C.,

Provider Business Mailing Address
First Line	:	194 PARK AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-3153
Country	:	US
Telephone Number	:	562-433-5565
Fax Number	:	562-433-3200

Provider Business Practice Location Address
First Line	:	194 PARK AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-3153
Country	:	US
Telephone Number	:	562-433-5565
Fax Number	:	562-433-3200

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	09/09/2011

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