Provider Demographics
NPI:1093942203
Name:WOLFF, SARAH ELIZABETH (OD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:WOLFF
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 SCHENLEY BAY
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-2983
Mailing Address - Country:US
Mailing Address - Phone:714-668-0953
Mailing Address - Fax:
Practice Address - Street 1:16816 CLARK AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-5702
Practice Address - Country:US
Practice Address - Phone:562-925-6591
Practice Address - Fax:562-867-8719
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13505T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist