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NPI Code Detail

MEDICARE: OLGA SAMPLAWSKI MMSC, PA-C

MEDICARE: OLGA SAMPLAWSKI MMSC, PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant0010-03880NC
2363AM0700XMedical Physician Assistant59732CA

General Provider Information

NPI Number : 1093055303
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLGA SAMPLAWSKI MMSC, PA-C
Provider Business Mailing Address
First Line : 2165 LARKSPUR LN
Second Line :
City : REDDING
State : CA
Zip : 96002-0600
Country : US
Telephone Number : 530-226-7419
Fax Number : 530-262-6844
Provider Business Practice Location Address
First Line : 1742 OREGON ST
Second Line :
City : REDDING
State : CA
Zip : 96001-1717
Country : US
Telephone Number : 530-646-7269
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2013
Last Update Date : 02/15/2024

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