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General NPI Number Information
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NPI Number | 1295930915
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Entity Type | Individual
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Provider Name | NICHOLAS OLSON MD
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Gender | Male
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 07/10/2019
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Provider Practice Location Address
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Address Line | 9898 GENESEE AVE
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City | LA JOLLA
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State | CA
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Zip | 92037-1205
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Country | US
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Telephone | 858-824-5005
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Fax |
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Provider Business Mailing Address
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Address Line | 10790 RANCHO BERNARDO RD APT 340
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City | SAN DIEGO
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State | CA
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Zip | 92127-5705
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Country | US
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Telephone | 858-824-5005
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | A107640
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A107640
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License Number State | CA
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