Individual
WALTER L OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
G55091
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0083810
—
CA
05
—
GR0083811
—
CA
05
—
GR0083812
—
CA
05
—
GR0083813
—
CA
05
—
GR0083814
—
CA
05
—
GR0083815
—
CA
05
—
GR0083816
—
CA
05
—
GR0083817
—
CA
05
—
ZZZ75341Z
—
CA
Enumeration date
02/10/2006
Last updated
09/19/2019
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