Individual
KEVIN W. OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7901 FROST ST, SAN DIEGO, CA 92123-2701
(858) 939-3400
(858) 939-4007
Mailing address
PO BOX 25033, SANTA ANA, CA 92799-5033
(714) 347-1000
(714) 647-1245
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G86467
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G864670
BLUE SHIELD OF CA
CA
05
—
00G864670
—
CA
Enumeration date
08/15/2006
Last updated
05/07/2021
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