Provider Demographics
NPI:1407910201
Name:WOLFE, PETER RICE (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:RICE
Last Name:WOLFE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5901 W OLYMPIC BLVD
Mailing Address - Street 2:SUITE # 401
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4667
Mailing Address - Country:US
Mailing Address - Phone:323-954-1072
Mailing Address - Fax:323-954-1081
Practice Address - Street 1:5901 W OLYMPIC BLVD
Practice Address - Street 2:SUITE # 401
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4667
Practice Address - Country:US
Practice Address - Phone:323-954-1072
Practice Address - Fax:323-954-1081
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG44086207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA92467Medicare UPIN