MEDICARE: DR. JEFFREY A. WOLF M.D.

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	207V00000X	Obstetrics & Gynecology Physician	G25318	CA

General Provider Information

NPI Number	:	1740314764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY A. WOLF M.D.

Provider Business Mailing Address
First Line	:	42 PENINSULA CTR
Second Line	:	#400
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90274-3506
Country	:	US
Telephone Number	:	714-226-6567
Fax Number	:

Provider Business Practice Location Address
First Line	:	42 PENINSULA CTR
Second Line	:	#400
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90274-3506
Country	:	US
Telephone Number	:	714-226-6567
Fax Number	:

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	07/08/2007

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