Provider Demographics
NPI:1922045046
Name:OLSON, ROBERT DON (DC,)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DON
Last Name:OLSON
Suffix:
Gender:M
Credentials:DC,
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:906 SYCAMORE AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-7828
Mailing Address - Country:US
Mailing Address - Phone:760-940-0500
Mailing Address - Fax:760-842-1518
Practice Address - Street 1:906 SYCAMORE AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-7828
Practice Address - Country:US
Practice Address - Phone:760-940-0500
Practice Address - Fax:760-842-1518
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CADC23676111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU71947Medicare UPIN