Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 20A17778 | CA |
NPI | 1003313453 |
---|---|
Provider Name | Michael Olsgaard |
First Address | Palm Springs, CA 92262-4872 |
Second Address | Palm Springs, CA 92262-4872 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2018 |
Last Update Date | 18/09/2020 |