Physician Compare National (NPI:1043238728)

HEALTHCARE PROVIDER: CHERYL LORRAINE OLSON M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1043238728
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0244286896
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080118000752
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	OLSON
	Individual professional last name
Provider First Name	CHERYL
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, DENVER
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SURGICAL ASSOCIATES OF LA JOLLA MEDICAL GROUP, INC.
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	9436105087
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	9850 GENESEE AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 660
	Group Practice or individual's line 2 address
City	LA JOLLA
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	920371231
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8584525054
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050324
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SCRIPPS MEMORIAL HOSPITAL LA JOLLA
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050503
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SCRIPPS MEMORIAL HOSPITAL - ENCINITAS
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y