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Individual

BENJAMIN THAYNE LARSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
25495 MEDICAL CENTER DR STE 204, MURRIETA, CA 92562
(951) 698-1901
(951) 364-3639
Mailing address
25495 MEDICAL CENTER DR STE 204, MURRIETA, CA 92562-4903
(951) 698-1901
(951) 698-8232

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A136009
CA

Other

Enumeration date
04/22/2009
Last updated
09/09/2024
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