Individual
DR. LARRY DAVID DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4060 4TH AVE STE 700, SAN DIEGO, CA 92103-2121
(609) 299-8500
(619) 297-1443
Mailing address
4060 4TH AVE STE 700, SAN DIEGO, CA 92103-2121
(609) 299-8500
(619) 297-1443
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G46528
CA
207XS0117X
Orthopaedic Surgery of the Spine Physician
G46528
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G465280
—
CA
Enumeration date
04/03/2006
Last updated
04/24/2026
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