Organization
DIABLO MEDICAL SUPPLY
Active
Other names
Stephen T. Larsen
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN T LARSEN (OWNER)
(925) 947-6099
Entity
Organization
Contact information
Practice address
1147 ALPINE RD, WALNUT CREEK, CA 94596-4401
(925) 947-6099
(925) 947-6624
Mailing address
1147 ALPINE RD, WALNUT CREEK, CA 94596-4401
(925) 947-6099
(925) 947-6624
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
100183
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100183
HMD RETAIL LICENSE NO.
CA
05
—
DME00939G
—
CA
Enumeration date
12/15/2006
Last updated
06/23/2008
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