Active NPI
Paul Sergei Wolf, M.D.
- Neurology Physician
- Fresno, CA
National Provider Identifier
1720191729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- A91087
- Practice address
- 1189 E Herndon Ave
Suite 101
Fresno, CA 93720-3167 - Phone
- (559) 434-5639
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A91087 | CA | |
| Neurology Physician | 2084N0400X | A91087 | CA | Primary |
Addresses
Primary practice location
1189 E Herndon Ave
Suite 101
Fresno, CA 93720-3167
Mailing address
1189 E Herndon Ave
Suite 101
Fresno, CA 93720-3167
Phone (559) 434-5639
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD 073534 L | Other | PA | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Children'S Specialty Medical Group, Inc. | Pediatrics | Past | Accepting new patients |
| Wolf Epilepsy Center | Past | Accepting new patients | |
| Wolf Epilepsy Center, Inc | Neurology | Past | Accepting new patients |
| Childrens Health Care Associates of New Jersey PC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Neurology with Special Qualifications in Child Neurology Physician
- Fresno, CA
- NPI 1790951713
-
- Neurology Physician
- Fresno, CA
- NPI 1982832812
-
- Pediatrics Physician
- Madera, CA
- NPI 1013968296
-
- Pediatrics Physician
- Voorhees, NJ
- NPI 1427152917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187049600000",
"number": "1720191729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1189 E HERNDON AVE",
"address_2": "SUITE 101",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203167",
"telephone_number": "559-434-5639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1189 E HERNDON AVE",
"address_2": "SUITE 101",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203167",
"telephone_number": "559-434-5639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLF",
"first_name": "PAUL",
"middle_name": "SERGEI",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2007-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A91087",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CA",
"license": "A91087",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "MD 073534 L",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.