Individual
FREDRICK NATHANIEL WOLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
606 ESPLANADE APT 5, REDONDO BEACH, CA 90277-4169
(310) 897-1613
Mailing address
606 ESPLANADE APT 5, REDONDO BEACH, CA 90277-4169
(310) 897-1613
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C38222
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C382220
—
CA
Enumeration date
05/20/2006
Last updated
01/19/2022
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