Provider Demographics
NPI:1821011834
Name:AFONIN, OLGA N (MD)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:N
Last Name:AFONIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:OLGA
Other - Middle Name:
Other - Last Name:SKOROKHOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1635 DIVISADERO ST
Mailing Address - Street 2:SUITE 625, BOX 1821
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:505 PARNASSUS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2204
Practice Address - Country:US
Practice Address - Phone:415-476-9694
Practice Address - Fax:415-476-9516
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0052453202D00000X
CAA87838207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A878380Medicaid
CA00A878380Medicare PIN
CA00A878380Medicaid