Individual
LARRY WARREN FOREMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1911 JOHNSON AVENUE, SAN LUIS OBISPO, CA 93401
(805) 543-5353
Mailing address
1945 CORBETT HIGHLANDS PL, ARROYO GRANDE, CA 93420-4933
(805) 459-8917
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
20A5055
CA
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
Primary
20A5055
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX50550
—
CA
Enumeration date
06/15/2006
Last updated
06/24/2016
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