MEDICARE: MS. ODILIA OLIVARES PA-C

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	363A00000X	Physician Assistant	149	CA

General Provider Information

NPI Number	:	1457352247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ODILIA OLIVARES PA-C

Provider Business Mailing Address
First Line	:	1172 N MACLAY AVE
Second Line	:
City	:	SAN FERNANDO
State	:	CA
Zip	:	91340-1328
Country	:	US
Telephone Number	:	818-898-1388
Fax Number	:	818-365-4031

Provider Business Practice Location Address
First Line	:	12540 PIERCE ST
Second Line	:
City	:	PACOIMA
State	:	CA
Zip	:	91331-1701
Country	:	US
Telephone Number	:	818-897-2193
Fax Number	:	818-899-3864

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1558362376 — MRS. JODY L. CHURCH P.N.P.
Practice Location Address:

12540 PIERCE ST
PACOIMA, CA
91331-1701

Practice Phone: 818-897-2193
Practice Fax: 818-899-3864

1285146977 — MAE KHRISTINE UBALDO ADRIANO CPNP
Practice Location Address:

12540 PIERCE ST
PACOIMA, CA
91331-1701

Practice Phone: 818-897-2193
Practice Fax:

1669039368 — HATHAWAY SYCAMORES CHILD AND FAMILY SERVICES
Practice Location Address:

12540 PIERCE ST
PACOIMA, CA
91331-1701

Practice Phone: 626-395-7100
Practice Fax: 626-395-7270

1851256143 — DAVID MORENO
Practice Location Address:

11016 NORRIS AVE
PACOIMA, CA
91331-2569

Practice Phone: 818-899-0201
Practice Fax:

1336004456 — LEONARDO GONZALEZ
Practice Location Address:

10445 LAUREL CANYON BLVD
PACOIMA, CA
91331-3605

Practice Phone: 818-472-5609
Practice Fax:

1043340631 — PATRICK HERNAN TALBOT LMFT
Practice Location Address:

12450 VAN NUYS BLVD STE 100
PACOIMA, CA
91331-1392

Practice Phone: 818-896-8366
Practice Fax:

Directions to “ MS. ODILIA OLIVARES PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.