Individual
MR. EDWIN K LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1737 FIRST ST, NAPA, CA 94559
(707) 226-5446
(707) 226-3772
Mailing address
1737 FIRST ST, NAPA, CA 94559
(707) 226-5446
(707) 226-3772
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OPT 105050 TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD01015051
—
CA
Enumeration date
11/27/2006
Last updated
01/25/2012
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