MEDICARE: DR. JEAN LORRAINE OLSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0901X	Public Health & General Preventive Medicine Physician	G51594	CA

General Provider Information

NPI Number	:	1447593728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEAN LORRAINE OLSON M.D.

Provider Business Mailing Address
First Line	:	6701 ROCKLEDGE DR
Second Line	:	SUITE 10018, MSC 7936
City	:	BETHESDA
State	:	MD
Zip	:	20892-7936
Country	:	US
Telephone Number	:	301-435-0397
Fax Number	:	301-480-1667

Provider Business Practice Location Address
First Line	:	6701 ROCKLEDGE DR
Second Line	:	SUITE 10018, MSC 7936
City	:	BETHESDA
State	:	MD
Zip	:	20892-7936
Country	:	US
Telephone Number	:	301-435-0397
Fax Number	:	301-480-1667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2013
Last Update Date	:	04/04/2013

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