Healthcare Provider Details

I. General information

NPI: 1417140674
Provider Name (Legal Business Name): DANIEL LLOYD WOLF L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3910 VISTA WAY STE 105
OCEANSIDE CA
92056-4513
US

IV. Provider business mailing address

3653 STRATA DR
CARLSBAD CA
92010-6589
US

V. Phone/Fax

Practice location:
  • Phone: 760-940-1363
  • Fax:
Mailing address:
  • Phone: 714-612-5048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 7692
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: