PHILIP L OLKIN (NPI# 1508897950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508897950 |
| Entity Type | Individual |
| Full Name | PHILIP L OLKIN |
| Credential | M.D. |
| Practice Address |
3302 Renner Dr Fortuna CA 95540-3120 |
| Mailing Address |
3302 Renner Dr Fortuna CA 95540-7103 |
| Practice Telephone | 7077253318 |
| Practice Fax Number | 7077259396 |
| Mailing Telephone | 7077253318 |
| Mailing Fax Number | 7077259396 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2018-04-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | G32253 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1699836981 | 05 | |
| CA | RHM53808F | 05 |
| Street Address |
3302 RENNER DR |
| City | FORTUNA |
| State | CA |
| Zip Code | 95540-3120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194189654 | St. Joseph Health Northern California, LLC | Clinic/Center | 3302 Renner Dr, Fortuna, CA 95540 | 2016-04-11 |
| 1699836981 | Philip L. Olkin, M.d. and C. Ray Jones, M.d. | Family Medicine | 3302 Renner Dr, Fortuna, CA 95540-3120 | 2006-12-12 |
| 1174558845 | Johnny Keith Coleman | Nurse Practitioner | 3302 Renner Dr, Fortuna, CA 95540-7103 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234787 | Remi Vista, Inc. | Community/Behavioral Health | 3000 Newburg, Fortuna, CA 95540 | 2020-01-21 |
| 1144867474 | Paula-marie Schneider | Registered Nurse | 3750 Rohnerville Rd., Fortuna, CA 95540 | 2019-12-05 |
| 1609265537 | Nancy Stinson Lollich | Physical Therapy Assistant | 2321 Newburg Road, Fortuna Rehabilitation and Wellness, Fortuna, CA 95540 | 2015-01-15 |
| 1730438151 | Heber House Inc. Dba Dermatology Center | Dermatology | 2404 Newburg Rd., Fortuna, CA 95540 | 2012-08-30 |
| 1104173418 | Michelle Leigh Hoopes | Physician Assistant | 3304 Renner Dr Suite B, Fortuna, CA 95540 | 2012-08-07 |
| 1205181526 | Constance Mitchell | Registered Nurse | Redwood Pediatrics, 3305 Renner Dr, Fortuna, CA 95540 | 2012-07-24 |
| 1730457177 | Joy Nadine Frasier | Counselor | 220 Wilson Ln., Fortuna, CA 95540 | 2011-12-13 |
| 1063791713 | Gardenside Eldercare, LLC | Residential Treatment Facility, Physical Disabilities | 529 9th Street, Fortuna, CA 95540 | 2011-08-12 |
| 1093025173 | Sheri A Jewett | Massage Therapist | 2655 Virginia Court, Fortuna, CA 95540 | 2010-10-07 |
| 1134371339 | Mariana Van Der Merwe | Pharmacist | 725 South Boulevard, Rite Aid Pharmacy, Fortuna, CA 95540 | 2008-10-21 |
| Find all providers in zip 95540 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942422688 | Stephanie S Dittmer | Family Medicine | 3750 Rohnerville Road, Fortuna, CA 95540 | 2007-05-03 |
| 1891708806 | Ruben E Brinckhaus | Family Medicine | 874 Main St, Fortuna, CA 95540-1926 | 2006-08-14 |
| 1427083187 | Clifford Ray Jones | Family Medicine | 3302 Renner Dr Ste A, Fortuna, CA 95540-7103 | 2006-07-11 |
| 1972554301 | Donald Irving Baird | Family Medicine | 3304 Renner Dr, Fortuna, CA 95540-7102 | 2006-05-12 |
| 1134179377 | Humboldt Medical Group | Family Medicine | 3306 Renner Dr, Fortuna, CA 95540-3120 | 2006-05-10 |
| 1871133504 | Lindsey Mendez | Family Medicine | 874 Main St, Fortuna, CA 95540-1926 | 2020-01-10 |
| 1407261001 | Jacqueline Proudfoot | Family Medicine | 3750 Rohnerville Road, Fortuna, CA 95540 | 2014-06-23 |
| 1508202821 | Margarette Jeannette Shegog | Family Medicine | 3306 Renner Dr, Fortuna, CA 95540 | 2013-05-14 |
| 1689971814 | Joni Laine Mcatee | Family Medicine | 3750 Rohnerville Road, Fortuna, CA 95540 | 2011-02-24 |
| 1952616211 | Cep America - California | Family Medicine | 3300 Renner Dr, Fortuna, CA 95540-3120 | 2010-08-11 |
| Find all providers in FORTUNA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.