Individual
GLORIA DE OLARTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
65 N MADISON AVE STE 406, PASADENA, CA 91101-2049
(626) 577-7965
(626) 577-4625
Mailing address
65 N MADISON AVE STE 406, PASADENA, CA 91101-2049
(626) 577-7965
(626) 577-4625
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A35537
CA
208200000X
Plastic Surgery Physician
Primary
A35537
CA
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
A35537
CA
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
A35537
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558542076
NPI
CA
01
—
953661841
TAX ID
CA
01
—
A35537
LICENCE
CA
Enumeration date
10/26/2006
Last updated
03/07/2023
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