SAMUEL OLSON MD
NPI 1548990153
Student in an Organized Health Care Education/Training Program in San Bernardino, CA

Q: What is Samuel Olson's NPI number?

The NPI number for Samuel Olson is 1548990153. It was assigned to this individual provider in the NPPES registry on June 15, 2022.

Q: What is Samuel Olson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Olson was last updated on June 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 15, 2022PECOS Enrolled

2101 N WATERMAN AVE, SAN BERNARDINO, CA 92404(909) 883-8711 Get Directions Write a Review

NPPES record last updated: June 15, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Samuel Olson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL OLSON MD (NPI 1548990153) is an individual student in an organized health care education/training program in San Bernardino, California and active in the NPI registry since June 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1548990153

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameSAMUEL OLSONCredential: MD

Location Address2101 N WATERMAN AVESan Bernardino, CA 92404-4836

Mailing Address1275 S Sycamore AveLos Angeles, CA 90019-1550 · (818) 665-6659

Phone(909) 883-8711

Sole ProprietorNo

Enumeration DateJune 15, 2022

NPPES CertifiedJune 2, 2022

✔ NPI 1548990153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2101 N WATERMAN AVE, San Bernardino, CA 92404

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Olson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICHOLAS WALTHER PA-C

Physician Assistant (Medical)