Kenneth E Wolf

Primary specialty

Ph.D. Medical GeneticsTaxonomy code 170100000X

License

AU552 Issued in CA

Practice address

12021 Wilmington Ave
Los Angeles, CA 90059-3019

Phone

(310) 668-4506

Fax

(310) 763-8909

NPI assigned

Jun 28, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902003478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17350 BRONTE PL",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913441027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 WILMINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593019",
            "telephone_number": "310-668-4506",
            "fax_number": "310-763-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "KENNETH",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "CA",
            "license": "AU552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johanna Wolf Petersen
• Aeroshikha Rose Wolf, MSN, RN
• Alexandria D Wolf
• Christine Wolf, CADC11, ICADC
• Graham Wolf, MD
• Marvin Sol Wolf, M.D.
• Miriam Wolf
• Monroe Anita Wolf
• Steve R Wolf, PH.DS.
• David Brian Wolfe, PH.D. LMFT 18137

• Ph.D. Medical Genetics in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Ph.D. Medical Genetics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.