Individual
CHARLES P LARSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Mailing address
1804 EMBARCADERO RD, SUITE 100, PALO ALTO, CA 94303-3341
(650) 723-4000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A18587
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A185870
BLUE SHIELD OF CA
CA
05
—
00A185870
—
CA
01
—
00A185870303
CALOPTIMA
CA
01
—
P00133572
RR MEDICARE
CA
Enumeration date
06/29/2006
Last updated
01/25/2017
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