Healthcare Provider Details

I. General information

NPI: 1902129273
Provider Name (Legal Business Name): NIKOLAJ WOLFSON MD A PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 09/04/2020
Certification Date: 09/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 SUTTER ST STE 207
SAN FRANCISCO CA
94115-3029
US

IV. Provider business mailing address

2300 SUTTER ST STE 207
SAN FRANCISCO CA
94115-3029
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-4400
  • Fax: 415-798-2213
Mailing address:
  • Phone: 415-221-4400
  • Fax: 415-798-2213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NIKOLAJ WOLFSON
Title or Position: PRESIDENT
Credential: MD
Phone: 415-221-4400