Individual
KENT RUSSELL OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
POISON CONTROL CTR, UCSF BOX 1369, SAN FRANCISCO, CA 94143-1369
(415) 502-6002
Mailing address
POISON CONTROL CTR, UCSF BOX 1369, SAN FRANCISCO, CA 94143-1369
(415) 502-6002
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G39696
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G396960
BLUE SHIELD
CA
05
—
00G396960
—
CA
Enumeration date
11/03/2005
Last updated
07/10/2007
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