Individual provider Active NPI

David L Olson, M.D.

  • Internal Medicine Physician
  • Carmichael, CA
National Provider Identifier
1962422618
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G41521 Issued in CA
Practice address
5900 Coyle Ave
Suite a
Carmichael, CA 95608-0400
Phone
(916) 332-1210
Fax
(916) 332-0207
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 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 G41521 CA Primary

Addresses

Primary practice location

5900 Coyle Ave
Suite a
Carmichael, CA 95608-0400

Mailing address

5900 Coyle Ave
Suite a
Carmichael, CA 95608-0400
Phone (916) 332-1210

Other identifiers 3

IdentifierTypeStateIssuer
00G415210MedicaidCA
G41521OtherCAMEDICAL LICENSE
1962422618OtherCANPI

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

State licenses

LicenseStateTypeSpecialty
41521CAMDGeneral Practice Dentistry
G41521CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1962422618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 COYLE AVE",
            "address_2": "SUITE A",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080400",
            "telephone_number": "916-332-1210",
            "fax_number": "916-332-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 COYLE AVE",
            "address_2": "SUITE A",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080400",
            "telephone_number": "916-332-1210",
            "fax_number": "916-332-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G41521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G415210",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G41521",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1962422618",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.