MEDICARE: DR. RICHARD LEE OLSON DC

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	111N00000X	Chiropractor	13851	CA
2	111NR0200X	Radiology Chiropractor	13851	CA

General Provider Information

NPI Number	:	1912092503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD LEE OLSON DC

Provider Business Mailing Address
First Line	:	18811 HUNTINGTON ST
Second Line	:	#100
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-6002
Country	:	US
Telephone Number	:	714-847-2422
Fax Number	:

Provider Business Practice Location Address
First Line	:	18811 HUNTINGTON ST
Second Line	:	#100
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-6002
Country	:	US
Telephone Number	:	714-847-2422
Fax Number	:

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	08/14/2012

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