MEDICARE: MORGAN WOLF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246RP1900X	Phlebotomy Technician	CPT 01006549	CA

General Provider Information

NPI Number	:	1508300526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN WOLF

Provider Business Mailing Address
First Line	:	1001 POTRERO AVE
Second Line	:	SFGH WARD 94 - BUILDING 90, 4TH FLOOR
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-3518
Country	:	US
Telephone Number	:	415-206-3385
Fax Number	:

Provider Business Practice Location Address
First Line	:	2460 22ND ST
Second Line	:	WARD 94
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-2815
Country	:	US
Telephone Number	:	415-206-3385
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2016
Last Update Date	:	12/09/2016

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