Individual provider Active NPI

Kristine Suzanne Olson Arthur, MD

  • Internal Medicine Physician
  • Fountain Valley, CA
National Provider Identifier
1003010950
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A95013 Issued in CA
Practice address
11420 Warner Ave
Fountain Valley, CA 92708-2529
Phone
(714) 549-1300
Fax
(714) 433-3100
NPI assigned
Jun 13, 2007
Last updated
Mar 30, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A95013 CA Primary

Addresses

Primary practice location

11420 Warner Ave
Fountain Valley, CA 92708-2529

Mailing address

2742 Dow Ave
Tustin, CA 92780-7242
Phone (714) 665-1600

Other identifiers 1

IdentifierTypeStateIssuer
00A950130MedicaidCA

Other names 1

  • Dr. Kristine Suzanne Olson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070803000609 CA Practitioner - Internal Medicine 8628169778 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A95013CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Internal Medicine CurrentSince Feb 1, 2011 Accepting new patients
Bristol Park Medical Group, Inc Internal Medicine Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

11420 Warner Ave
Fountain Vly, CA 92708
Phone (714) 549-1300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

24268 El Toro Rd
Laguna Woods, CA 92637
Phone (657) 241-8455

2742 Dow Ave
Tustin, CA 92780
Phone (714) 665-1600

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1003010950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2742 DOW AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807242",
            "telephone_number": "714-665-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11420 WARNER AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082529",
            "telephone_number": "714-549-1300",
            "fax_number": "714-433-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARTHUR",
        "first_name": "KRISTINE",
        "middle_name": "SUZANNE OLSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A95013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A950130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "OLSON",
            "middle_name": "SUZANNE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.