Provider Demographics
NPI:1407397326
Name:OLYAIE, ASHKON (PARAMEDIC)
Entity Type:Individual
Prefix:
First Name:ASHKON
Middle Name:
Last Name:OLYAIE
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32530 ALMADEN BLVD
Mailing Address - Street 2:APT 120
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-2910
Mailing Address - Country:US
Mailing Address - Phone:510-921-9605
Mailing Address - Fax:
Practice Address - Street 1:32530 ALMADEN BLVD
Practice Address - Street 2:APT 120
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-2910
Practice Address - Country:US
Practice Address - Phone:510-921-9605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP34606146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic