Individual
MICHAEL PHILLIP WOLFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1042 N MOUNTAIN AVE, BOX 351, UPLAND, CA 91786-3695
(909) 908-9137
Mailing address
1042 N MOUNTAIN AVE, BOX 351, UPLAND, CA 91786-3695
(909) 908-9137
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN452631
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430079036
RAILROAD MEDICARE
—
05
—
RN4526310
—
CA
Enumeration date
12/15/2005
Last updated
05/17/2010
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