Provider Demographics
NPI:1063679488
Name:WOLFF AND WOLFF
Entity Type:Organization
Organization Name:WOLFF AND WOLFF
Other - Org Name:EL DORADO FOOT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:WOLFF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:916-351-1586
Mailing Address - Street 1:PO BOX 1853
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-1853
Mailing Address - Country:US
Mailing Address - Phone:916-835-2724
Mailing Address - Fax:916-351-5674
Practice Address - Street 1:3175 TURNER ST
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-5724
Practice Address - Country:US
Practice Address - Phone:916-835-2724
Practice Address - Fax:916-351-5674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3595213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT88708Medicare UPIN