Provider Demographics
NPI:1609233774
Name:OLIMPIADI, YULIYA BORISOVNA (MD)
Entity Type:Individual
Prefix:DR
First Name:YULIYA
Middle Name:BORISOVNA
Last Name:OLIMPIADI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N STATE ST
Mailing Address - Street 2:CT-A7D
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1029
Mailing Address - Country:US
Mailing Address - Phone:323-409-6931
Mailing Address - Fax:
Practice Address - Street 1:11850 BLACKFOOT ST NW STE 200
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2593
Practice Address - Country:US
Practice Address - Phone:763-236-0808
Practice Address - Fax:763-236-6065
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140213208600000X
GA89119208600000X
MN74146208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery