Individual
BRETT LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
14 MONARCH BAY PLZ # 122, DANA POINT, CA 92629-3424
(949) 350-7508
Mailing address
14 MONARCH BAY PLZ # 122, DANA POINT, CA 92629-3424
(949) 350-7508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
51996
CA
363A00000X
Physician Assistant
Primary
51996
CA
Other
Enumeration date
10/06/2014
Last updated
04/24/2019
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