Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A95013 | CA |
Y | 111NI0900X | Internist | A95013 | CA |
NPI | 1003010950 |
---|---|
Provider Name | Dr. Kristine Suzanne Olson Arthur |
First Address | Tustin, CA 92780-7242 |
Second Address | Fountain Valley, CA 92708-2529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 30/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A950130 | (05) | CA |