Alexander Christopher Wulff, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A21410 Issued in CA

Practice address

4560 Admiralty Way Ste 100
Marina del Rey, CA 90292-5424

Phone

(310) 827-3700

NPI assigned

Sep 16, 2021

Reactivated

Jun 8, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Specialty

Family PracticeAlso: Sports Medicine

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1366112724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY STE 100",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925424",
            "telephone_number": "310-827-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11710 Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900251503",
            "country_code": "US",
            "telephone_number": "310-873-4414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WULFF",
        "first_name": "ALEXANDER",
        "middle_name": "CHRISTOPHER",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-16",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "deactivation_date": "2022-05-14",
        "reactivation_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A21410",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A21410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSTEOPATHIC PHYSICIAN AND SURGEON",
            "identifier": "20A21410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Shanhat Yacob
• Arthur Yang, MD
• Sarah Yang
• Yun K Yang

• Family Medicine Physician in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.