Provider Demographics
NPI:1982921706
Name:WOLF, MICHAEL E (MD, MS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:WOLF
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 N BARRANCA AVE # 2483
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1722
Mailing Address - Country:US
Mailing Address - Phone:213-375-8665
Mailing Address - Fax:
Practice Address - Street 1:440 N BARRANCA AVE # 2483
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1722
Practice Address - Country:US
Practice Address - Phone:213-375-8665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN660172083X0100X
CAA1185232083C0008X, 2083A0100X, 208D00000X, 2083X0100X
CAP17809146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083C0008XAllopathic & Osteopathic PhysiciansPreventive MedicineClinical Informatics
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic