Individual
LARRY KUSSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15243 VANOWEN ST, VAN NUYS, CA 91405-3632
(818) 782-6110
Mailing address
PO BOX 190, SIMI VALLEY, CA 93062-0190
(805) 522-5940
(805) 522-6401
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A20370
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A203700
—
CA
Enumeration date
05/11/2006
Last updated
08/21/2007
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