Provider Demographics
NPI:1841376704
Name:KRIJANOVSKI, OLEG I (MD, PHD)
Entity type:Individual
Prefix:
First Name:OLEG
Middle Name:I
Last Name:KRIJANOVSKI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:510-204-1591
Mailing Address - Fax:510-204-6440
Practice Address - Street 1:2001 DWIGHT WAY
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-2608
Practice Address - Country:US
Practice Address - Phone:510-204-1591
Practice Address - Fax:510-204-6440
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301074606207R00000X, 207RX0202X
CAA105568207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA105568OtherSTATE MEDICAL LICENSE
MI4776408Medicaid
MII42023Medicare UPIN