Basic Information
| Provider Information | |||||||||
| NPI: | 1205098456 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WOLFSOHN | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | BENJAMIN | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3400 DATA DRIVE | ||||||||
| Address2: | PHYSICIAN SUPPORT SERVICES, 2ND FLOOR | ||||||||
| City: | RANCHO CORDOVA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956707956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8052789599 | ||||||||
| FaxNumber: | 8052781220 | ||||||||
| Practice Location | |||||||||
| Address1: | 64 EAST DAILY DRIVE | ||||||||
| Address2: | |||||||||
| City: | CAMARILLO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930105803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053848071 | ||||||||
| FaxNumber: | 8054378717 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2008 | ||||||||
| LastUpdateDate: | 07/07/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | R70150 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0200X | 20A11186 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.