Provider Demographics
NPI:1750352803
Name:NORDLING, OLAF BRANDT (MD)
Entity type:Individual
Prefix:MR
First Name:OLAF
Middle Name:BRANDT
Last Name:NORDLING
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6073 MADRA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-3943
Mailing Address - Country:US
Mailing Address - Phone:619-463-5811
Mailing Address - Fax:619-528-3361
Practice Address - Street 1:4647 ZION AVENUE
Practice Address - Street 2:KAISER PERMANENTE MEDICAL CENTER SAN DIEGO
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92112
Practice Address - Country:US
Practice Address - Phone:619-528-6973
Practice Address - Fax:619-528-3361
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2021-12-06
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Provider Licenses
StateLicense IDTaxonomies
CAG682082085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology