Individual
DR. LARRY J. CARDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6555 COYLE AVE STE 190, CARMICHAEL, CA 95608-0303
(916) 536-2582
(916) 536-2583
Mailing address
3400 DATA DR, PHYSICIAN SUPPORT SERVICES, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A22534
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
A22534
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A225340
—
CA
Enumeration date
06/21/2006
Last updated
02/06/2019
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