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Individual

JAMES RICHARD LAROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1060 N 13TH AVE, UPLAND, CA 91786-3785
(909) 985-2555
(909) 985-0068
Mailing address
1060 N 13TH AVE, UPLAND, CA 91786-3402
(909) 985-2555
(909) 985-0068

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E1467
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
480029125
MEDICARE RAILROAD
CA
01
6501520001
MEDICARE NSC
CA
05
ZZZ80594Z
CA
Enumeration date
10/18/2006
Last updated
10/09/2012
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