Healthcare Provider Details

I. General information

NPI: 1366474181
Provider Name (Legal Business Name): BERNARD ARTHUR WOLF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 HIGH SCHOOL AVE STE 300
CONCORD CA
94520-1815
US

IV. Provider business mailing address

2415 HIGH SCHOOL AVE STE 300
CONCORD CA
94520-1815
US

V. Phone/Fax

Practice location:
  • Phone: 925-685-8894
  • Fax: 925-609-7558
Mailing address:
  • Phone: 925-685-8894
  • Fax: 925-609-7558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA29305
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: