Individual provider Active NPI

Mitchel James Olson, M.D.

  • General Practice Physician
  • Carlsbad, CA
National Provider Identifier
1780820548
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G65684 Issued in CA
Practice address
1902 Wright PL
Suite 200
Carlsbad, CA 92008-6583
Phone
(760) 634-6755
NPI assigned
Dec 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G65684 CA Primary

Addresses

Primary practice location

1902 Wright PL
Suite 200
Carlsbad, CA 92008-6583

Mailing address

1902 Wright PL
Suite 200
Carlsbad, CA 92008-6583
Phone (760) 634-6755

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G65684CAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1230508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230508800000",
    "number": "1780820548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 WRIGHT PL",
            "address_2": "SUITE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920086583",
            "telephone_number": "760-634-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 WRIGHT PL",
            "address_2": "SUITE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920086583",
            "telephone_number": "760-634-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "MITCHEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-29",
        "last_updated": "2008-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G65684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; 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.