Wolfus, George Mario

Wolfus, George Mario is an sole proprietor health care provider with primary practice located at 17149 Citronia St , Northridge CA 91325-1931. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wolfus, George Mario can be contacted via phone (818) 341-1190.

Contact Information

Primary practice address
17149 Citronia St Northridge CA 91325-1931
Phone: (818) 341-1190
Fax: (818) 341-1190
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4908T California

Profile Details

NPI number 1487644365
LBN Legal business name Wolfus, George Mario
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2005
Last updated Nov 16th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487644365 NPPES
California Other SD0049080 BLUE SHIELD
California MEDICAID SD0049080 BLUE SHIELD

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