Healthcare Provider Details

I. General information

NPI: 1902816903
Provider Name (Legal Business Name): TAURA MICHELLE OLFUS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS TAURA MICHELLE JOHNSON

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 01/04/2026
Certification Date: 01/04/2026
Deactivation Date: 08/22/2006
Reactivation Date: 09/15/2006

III. Provider practice location address

23501 CINEMA DR STE 100
VALENCIA CA
91355-5429
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 661-367-9200
  • Fax:
Mailing address:
  • Phone: 702-579-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A9281
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: