Individual
LARISSA NADIA LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6633 TELEPHONE RD STE 100, VENTURA, CA 93003-5569
(310) 644-9121
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8707
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A118359
CA
Other
Enumeration date
06/18/2010
Last updated
01/04/2024
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