Individual
INGRID M OLSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
255 E BONITA AVE BLDG 9, POMONA, CA 91767-1923
(909) 301-8897
Mailing address
11100 4TH ST APT G306, RANCHO CUCAMONGA, CA 91730-0909
(603) 718-4179
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1516
NH
Other
Enumeration date
09/20/2017
Last updated
12/16/2021
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