Individual
ROBERT C WOLLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1328 22ND ST, SANTA MONICA, CA 90404-2032
(310) 829-8913
(310) 315-6168
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
(626) 775-3514
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
G78624
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G786240
—
CA
01
—
920001237
RR MEDICARE - SJHC
CA
01
—
WG78624E
MEDICARE SJMC
CA
01
—
WG78624F
MEDICARE SJHC
CA
01
—
WG78624I
MEDICARE LCM
CA
01
—
WG78624J
MEDICARE SP
CA
01
—
WG78624K
MEDICARE SJO
—
Enumeration date
12/09/2005
Last updated
11/23/2020
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