Healthcare Provider Details

I. General information

NPI: 1982921706
Provider Name (Legal Business Name): MICHAEL E WOLF MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 N BARRANCA AVE # 2483
COVINA CA
91723-1722
US

IV. Provider business mailing address

440 N BARRANCA AVE # 2483
COVINA CA
91723-1722
US

V. Phone/Fax

Practice location:
  • Phone: 213-375-8665
  • Fax:
Mailing address:
  • Phone: 213-375-8665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number66017
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code2083C0008X
TaxonomyClinical Informatics Physician
License NumberA118523
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberA118523
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA118523
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP17809
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberA118523
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: