MEDICARE: SIMON OLSTEIN MD

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
1	2083A0300X	Addiction Medicine (Preventive Medicine) Physician	8589	AZ

General Provider Information

NPI Number	:	1972896520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMON OLSTEIN MD

Provider Business Mailing Address
First Line	:	5656 E ORANGE BLOSSOM LN STE 5
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-8139
Country	:	US
Telephone Number	:	602-601-7429
Fax Number	:	602-601-7428

Provider Business Practice Location Address
First Line	:	5656 E ORANGE BLOSSOM LN STE 5
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-8139
Country	:	US
Telephone Number	:	602-601-7429
Fax Number	:	602-601-7428

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2011
Last Update Date	:	06/04/2026

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Directions to “ SIMON OLSTEIN MD” Practice Location

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