MEDICARE: MR. CHRISTIAN ERIC OLAFSEN MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	A192562	CA

General Provider Information

NPI Number	:	1790428837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTIAN ERIC OLAFSEN MD

Provider Business Mailing Address
First Line	:	12745 BAY LN
Second Line	:
City	:	APPLE VALLEY
State	:	CA
Zip	:	92308-6737
Country	:	US
Telephone Number	:	760-953-3524
Fax Number	:

Provider Business Practice Location Address
First Line	:	12745 BAY LN
Second Line	:
City	:	APPLE VALLEY
State	:	CA
Zip	:	92308-6737
Country	:	US
Telephone Number	:	760-953-3524
Fax Number	:

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

Provider Enumeration Date	:	04/17/2022
Last Update Date	:	07/01/2025

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