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General NPI Number Information
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NPI Number | 1710075411
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Entity Type | Individual
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Provider Name | PHILLIP A WOLFE M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5575 W LAS POSITAS BLVD SUITE 320
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City | PLEASANTON
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State | CA
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Zip | 94588-5801
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Country | US
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Telephone | 925-460-8167
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Fax | 925-460-0913
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Provider Business Mailing Address
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Address Line | 5575 W LAS POSITAS BLVD SUITE 320
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City | PLEASANTON
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State | CA
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Zip | 94588-5801
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Country | US
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Telephone | 925-460-8167
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | G83272
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License Number State | CA
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