NPIMap

Individual provider Active NPI

Robert Olvera, MD

  • Family Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1356322523
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G52960 Issued in CA
Practice address
1212 W 17TH St
Santa Ana, CA 92706-3418
Phone
(714) 954-0432
Fax
(714) 796-6265
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G52960 CA Primary

Addresses

Primary practice location

1212 W 17TH St
Santa Ana, CA 92706-3418

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
00G529600MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orange Coast Memorial Medical Center Past Accepting new patients
Children's Hospital of Orange County Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Children's Hospital at Mission Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Bristol Park Medical Group, Inc Family Medicine Past Accepting new patients

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1356322523",
    "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": "1212 W 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063418",
            "telephone_number": "714-954-0432",
            "fax_number": "714-796-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLVERA",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G52960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G529600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.