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Gregory P Olsen

Emergency Medicine

Allopathic & Osteopathic Physicians

300 W Pueblo St, Santa Barbara, CA 93105-4311

PECOS Enrollment

This provider is enrolled in PECOS as GREGORY OLSEN.

Based on the most recent information from CMS, provider Gregory P Olsen is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 9:43 AM.

Profile Details

Provider ID
1598701658
Provider Type
Individual
Full Name
Olsen, Gregory P
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
6/20/2006
Last Updated
4/1/2010

Contact Information

Practice Location

300 W Pueblo St, Santa Barbara, CA 93105-4311

(805) 682-7111

Unlisted Fax

Mailing Location

PO Box 10040, Westminster, CA 92685-0040

(800) 358-8179

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License G56830 California

Provider Identifiers

ID	Description	Issuer
ID 00G568300	Description Medicaid	Issuer Unlisted California

Gregory P Olsen

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Salvucci, Angelo A

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Yao, Steven K

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Vu, Christopher Son

Kroes, Jeremy Scott

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