Individual provider Active NPI

John Michael Olichney, M.D.

  • Neurology Physician
  • San Diego, CA
National Provider Identifier
1689699969
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G68500 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9001
Phone
(858) 657-8540
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X G68500 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9001

Mailing address

3350 La Jolla Village Dr
San Diego, CA 92161-0002
Phone (858) 642-3685

Other identifiers 1

IdentifierTypeStateIssuer
00G685000MedicaidCA

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
I20061103000512 CA Practitioner - Neurology 5193722155 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68500CAMDPharmacist
G68500CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Feb 1, 2021 Accepting new patients
Regents of the Univ of Ca Neurology CurrentSince Oct 1, 2006 Accepting new patients
Regents of the Univ of Ca CurrentSince Oct 1, 2006 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the University of Ca CurrentSince Feb 1, 2021 Accepting new patients
Essent PRMC LP Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

3160 Folsom Blvd
Ste 1400
Sacramento, CA 95816
Phone (916) 731-1831

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

100 N Wiget Ln
Ste 150
Walnut Creek, CA 94598
Phone (855) 420-2612

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1689699969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-642-3685",
            "fax_number": "858-552-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039001",
            "telephone_number": "858-657-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLICHNEY",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G68500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G685000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.