Healthcare Provider Details

I. General information

NPI: 1821232026
Provider Name (Legal Business Name): WESLEY SOKOLOSKY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2009
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 DEER VALLEY RD APT 2K
SAN RAFAEL CA
94903-5522
US

IV. Provider business mailing address

600 DEER VALLEY RD APT 2K
SAN RAFAEL CA
94903-5522
US

V. Phone/Fax

Practice location:
  • Phone: 415-827-2111
  • Fax:
Mailing address:
  • Phone: 415-827-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberC31305
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: