Provider Demographics
NPI:1154485183
Name:WOLFENDEN, WILLIAM JAMES JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JAMES
Last Name:WOLFENDEN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 DANIEL BURNHAM CT
Mailing Address - Street 2:SUITE 368C
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5455
Mailing Address - Country:US
Mailing Address - Phone:415-441-9565
Mailing Address - Fax:415-441-9587
Practice Address - Street 1:1 DANIEL BURNHAM CT
Practice Address - Street 2:SUITE 368C
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5455
Practice Address - Country:US
Practice Address - Phone:415-441-9565
Practice Address - Fax:415-441-9587
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAA212792082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A212790Medicare UPIN