Individual
LARISA NADUKHOVSKAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
301 INDUSTRIAL RD, SAN CARLOS, CA 94070-2603
(650) 596-4100
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(650) 596-4100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20A8321
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX83210
—
CA
Enumeration date
07/15/2006
Last updated
02/04/2022
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