Individual
MR. MITCHELL BLAIN OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
757 WESTWOOD PLZ, LOS ANGELES, CA 90095-8358
(310) 825-9111
Mailing address
5767 WEST CENTURY BLVD STE 400, LOS ANGELES, CA 90095-8358
(310) 301-8771
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
9808115-3102
UT
367500000X
Certified Registered Nurse Anesthetist
137573
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95001815
CA
Other
Enumeration date
05/11/2022
Last updated
09/22/2022
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