Individual
DR. LARRY I EMDUR
Active
Individual
DR. LARRY I EMDUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO, PHD
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
20A4940
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00AX4940
MEDI-CAL
CA
01
—
20A4940
LICENSE
CA
01
—
ZZZ39696Z
BLUE CROSS
CA
Enumeration date
07/22/2005
Last updated
06/06/2022
Update your record
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