Provider Demographics
NPI:1861592982
Name:OLAES, LAMBERTO SALUD (MD)
Entity type:Individual
Prefix:DR
First Name:LAMBERTO
Middle Name:SALUD
Last Name:OLAES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 N VIRGIL AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-2017
Mailing Address - Country:US
Mailing Address - Phone:323-664-7628
Mailing Address - Fax:323-664-7647
Practice Address - Street 1:1267 N VIRGIL AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-2017
Practice Address - Country:US
Practice Address - Phone:323-664-7628
Practice Address - Fax:323-664-7647
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39580207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOA395800Medicaid
A28911Medicare UPIN
CAOOA395800Medicaid