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1902816903 NPI number — TAURA MICHELLE OLFUS DO

NPI Number: 1902816903
Health Care Provider/Practitioner: TAURA MICHELLE OLFUS DO

Information about “1902816903” NPI (TAURA MICHELLE OLFUS DO) exists in 1902816903 in HTML format HTML  |  1902816903 in plain Text format TXT  |  1902816903 in PDF (Portable Document Format) PDF  |  1902816903 in an XML format XML  formats.

NPI Number : 1902816903 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1902816903",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OLFUS",
    "FirstName": "TAURA",
    "MiddleName": "MICHELLE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "DO",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "JOHNSON",
    "OtherFirstName": "TAURA",
    "OtherMiddleName": "MICHELLE",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 35380",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAS VEGAS",
    "MailingAddressStateName": "NV",
    "MailingAddressPostalCode": "89133-5380",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "702-579-3203",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "23501 CINEMA DR STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "VALENCIA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91355-5429",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "661-367-9200",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/09/2006",
    "LastUpdateDate": "01/04/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": "08/22/2006",
    "NPIReactivationDate": "09/15/2006",
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "20A9281",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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