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General NPI Number Information
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NPI Number | 1164805263
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Entity Type | Organization
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Legal Business Name | CASSANDRA OHLSEN, M.D., INC.
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 154 14TH ST
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City | PACIFIC GROVE
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State | CA
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Zip | 93950-2725
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Country | US
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Telephone | 831-277-2220
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 51520
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City | PACIFIC GROVE
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State | CA
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Zip | 93950-6520
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Country | US
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Telephone | 831-277-2220
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/SOLE DIRECTOR
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Name | CASSANDRA OHLSEN
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Credential | M.D.
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Telephone | 831-277-2220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G56448
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License Number State | CA
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