Provider Demographics
NPI:1114014966
Name:WOLFF, LESLEY JOEL (DPM MS)
Entity Type:Individual
Prefix:DR
First Name:LESLEY
Middle Name:JOEL
Last Name:WOLFF
Suffix:
Gender:M
Credentials:DPM MS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:909 HYDE ST
Mailing Address - Street 2:STE 230
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4845
Mailing Address - Country:US
Mailing Address - Phone:415-474-3668
Mailing Address - Fax:415-775-4589
Practice Address - Street 1:909 HYDE ST
Practice Address - Street 2:STE 230
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4845
Practice Address - Country:US
Practice Address - Phone:415-474-3668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI52213E00000X
CAE15520213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E15520Medicare ID - Type Unspecified