Provider Demographics
NPI:1104013820
Name:OLAFSON, LINDA R (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:R
Last Name:OLAFSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:317 N EL CAMINO REAL
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2811
Mailing Address - Country:US
Mailing Address - Phone:760-944-2986
Mailing Address - Fax:760-479-0875
Practice Address - Street 1:317 N EL CAMINO REAL
Practice Address - Street 2:SUITE 104
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2811
Practice Address - Country:US
Practice Address - Phone:760-944-2986
Practice Address - Fax:760-479-0875
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2015-01-07
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Provider Licenses
StateLicense IDTaxonomies
CAG60923207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE90523Medicare UPIN