Individual
NICHOLAS WIESSNER LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Mailing address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
A155442
CA
2084N0600X
Clinical Neurophysiology Physician
Primary
A155442
CA
Other
Enumeration date
05/09/2016
Last updated
11/10/2023
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