Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 13851 | CA |
N | 111NR0200X | Radiology | 13851 | CA |
N | 213ER0200X | Radiology | 13851 | CA |
NPI | 1912092503 |
---|---|
Provider Name | Dr. Richard Lee Olson |
First Address | Huntington Beach, CA 92648-6002 |
Second Address | Huntington Beach, CA 92648-6002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 14/08/2012 |