Individual
STEVEN EDWIN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G41825
CA
207RI0200X
Infectious Disease Physician
Primary
G41825
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730180415
GROUP NPI
—
01
—
ZZZ31887Z
GROUP SITE NUMBER
—
Enumeration date
11/10/2005
Last updated
12/29/2010
Update your record
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