Healthcare Provider Details

I. General information

NPI: 1730247990
Provider Name (Legal Business Name): MARTIN NEIL OLSEN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6435 CAMINITO BLYTHEFIELD SUITE D
LA JOLLA CA
92037-5851
US

IV. Provider business mailing address

6435 CAMINITO BLYTHEFIELD SUITE E
LA JOLLA CA
92037-5851
US

V. Phone/Fax

Practice location:
  • Phone: 858-454-4557
  • Fax: 858-454-3847
Mailing address:
  • Phone: 858-454-4557
  • Fax: 858-454-3847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC20729
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: