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NPI Code Detail

MEDICARE: BRIAN WOLF MD

MEDICARE: BRIAN WOLF MD
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207RH0003XHematology & Oncology PhysicianA200123CA

General Provider Information

NPI Number : 1730640772
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN WOLF MD
Provider Business Mailing Address
First Line : 2001 SANTA MONICA BLVD STE 560W
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-2182
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2001 SANTA MONICA BLVD STE 560W
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-2182
Country : US
Telephone Number : 310-453-5654
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2019
Last Update Date : 07/30/2025

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Directions to “ BRIAN WOLF MD” Practice Location

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