Individual
DR. LARRY MARC GERSTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24331 EL TORO RD STE 200, LAGUNA WOODS, CA 92637-3116
(949) 586-3200
(949) 900-2116
Mailing address
24331 EL TORO RD STE 200, LAGUNA WOODS, CA 92637-3116
(949) 586-3200
(949) 900-2116
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
G50397
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G503970
—
CA
01
—
00G503970G89
CAL-OPTIMA
CA
01
—
RR2000 19525
MEDICARE RAILROAD
CA
Enumeration date
05/27/2005
Last updated
06/19/2020
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