THEODORE OLSON M.D. NPI 1417041591

NPI Information

NPI: 1417041591
Provider Name: THEODORE OLSON, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
196 SOTOYOME ST
SANTA ROSA, CA
ZIP 95405
Phone: (707) 528-0565
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Theodore Olson, M.D. is a specialist in Santa Rosa, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Theodore Olson, M.D. NPI is 1417041591. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

196 SOTOYOME ST
SANTA ROSA, CA
ZIP 95405-800
Phone: (707) 528-0565
Fax: (707) 528-6403

The enumeration date for this NPI number is 10/3/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		A212232	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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