Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | G25149 | CA |
NPI | 1194733428 |
---|---|
Provider Name | James D Wolfe |
First Address | San Jose, CA 95117-1840 |
Second Address | San Jose, CA 95117-1840 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 10/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A42547 | (02) |