Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A117835 | CA |
Y | 208600000X | Surgeon | A117835 | CA |
N | 2086S0102X | Surgical Critical Care | A117385 | CA |
N | 2086S0102X | Surgical Critical Care | MD460329 | PA |
N | 2086S0127X | Trauma Surgeon | A117385 | CA |
NPI | 1174844815 |
---|---|
Provider Name | Dr. Erik Joseph Olson |
First Address | San Diego, CA 92134-3400 |
Second Address | San Diego, CA 92134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2010 |
Last Update Date | 15/10/2019 |