Healthcare Provider Details

I. General information

NPI: 1588961759
Provider Name (Legal Business Name): MARGARET OLMSTED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2011
Last Update Date: 02/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4143 ALLA RD
LOS ANGELES CA
90066-5701
US

IV. Provider business mailing address

PO BOX 90818
LOS ANGELES CA
90009-0818
US

V. Phone/Fax

Practice location:
  • Phone: 310-968-7934
  • Fax:
Mailing address:
  • Phone: 877-563-4820
  • Fax: 310-695-2787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 7964
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: