Jack C Wolfe, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G29972 Issued in CA

Practice address

1625 E Main St
Ste. 100
El Cajon, CA 92021-5211

Phone

(619) 442-9896

Fax

(619) 442-2245

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1417055948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 E MAIN ST",
            "address_2": "STE. 100",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215211",
            "telephone_number": "619-442-9896",
            "fax_number": "619-442-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 E MAIN ST",
            "address_2": "STE. 100",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215211",
            "telephone_number": "619-442-9896",
            "fax_number": "619-442-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "JACK",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G29972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G299720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katharine G Winter, MSCN
• Alesia Wise, RDHAP
• Eric Richard Wise, D.C.
• Zachary Wittusen
• Gary James Wokuluk, DDS
• Samantha Marie Woll
• Jordan Wong, PA
• Nicholas Woo-Vonhoogenstyn
• Julie Szymanski Wood, P.T.
• Tabitha Wood, CCC-SLP

• Emergency Medicine Physician in El Cajon, CA
• Providers in El Cajon, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.