Provider Demographics
NPI:1679564942
Name:OLFF, MICHAEL WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:OLFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 RIVERLAKE RD
Mailing Address - Street 2:STE. L.
Mailing Address - City:DISCOVERY BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94514-9334
Mailing Address - Country:US
Mailing Address - Phone:925-240-6533
Mailing Address - Fax:925-778-8109
Practice Address - Street 1:1555 RIVERLAKE RD
Practice Address - Street 2:STE. L.
Practice Address - City:DISCOVERY BAY
Practice Address - State:CA
Practice Address - Zip Code:94514-9334
Practice Address - Country:US
Practice Address - Phone:925-240-6533
Practice Address - Fax:925-778-8109
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12493111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0124930Medicare ID - Type Unspecified