Philip L Olkin, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G32253 Issued in CA

Practice address

3302 Renner Dr
Fortuna, CA 95540-3120

Phone

(707) 725-3318

Fax

(707) 725-9396

NPI assigned

Jul 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• St. Joseph Health Northern California, LLC

  • Critical Access Hospital
  • Fortuna, CA
  • NPI 1043292303
  Medicare reassignment NPD

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1508897950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3302 RENNER DR",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955407103",
            "telephone_number": "707-725-3318",
            "fax_number": "707-725-9396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 RENNER DR",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955403120",
            "telephone_number": "707-725-3318",
            "fax_number": "707-725-9396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLKIN",
        "first_name": "PHILIP",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G32253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699836981",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM53808F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Noelle Murray, PA
• Julia Muse
• Neal E Feuerman, MD, Inc
• Noreen Edwards Expressive Arts, Licensed Clinical Social Worker
• North Coast Emergency Physicians
• Open Door Community Health Centers
• Joseph A Ortola, DDS
• Pacific Memorial Anesthesia Care, Inc
• Paul Stauffer, P.C.
• Kristin Leigh Perkins, LCSW

• Family Medicine Physician in Fortuna, CA
• Providers in Fortuna, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.