Individual
DR. DANIEL WOHLGELERNTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 20TH ST, SUITE 590, SANTA MONICA, CA 90404-2050
(310) 315-0101
(310) 453-4145
Mailing address
2021 SANTA MONICA BLVD, SUITE 212E, SANTA MONICA, CA 90404-2225
(310) 401-3390
(310) 453-4348
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G55314
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G553140
—
CA
01
—
952976030
GROUP TAX IDENTIFICATION
CA
Enumeration date
07/19/2006
Last updated
06/22/2020
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