Healthcare Provider Details

I. General information

NPI: 1891085148
Provider Name (Legal Business Name): KRISTOFF ANDERSON OLSON MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HILLMONT AVE
VENTURA CA
93003-1651
US

IV. Provider business mailing address

800 S VICTORIA AVE, L4615 VCHCA - PHYSICIAN SERVICES
VENTURA CA
93009-0003
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-6556
  • Fax: 805-652-3252
Mailing address:
  • Phone: 805-677-5181
  • Fax: 805-677-5304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA124154
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: