Organization
LARISSA LARSEN DERMATOLOGY INC
Active
Organization
LARISSA LARSEN DERMATOLOGY INC
Active
Other names
Camarillo Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
LARISSA NADIA LARSEN MD (OWNER)
(805) 807-2367
Entity
Organization
Contact information
Practice address
2460 N PONDEROSA DR STE A117, CAMARILLO, CA 93010-2468
(805) 430-0002
(805) 389-1245
Mailing address
2460 N PONDEROSA DR STE A117, CAMARILLO, CA 93010-2468
(805) 430-0002
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
06/09/2020
Last updated
11/27/2023
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