Individual
MRS. DIANA KAY LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
23110 ATLANTIC CIR, SUITE A, MORENO VALLEY, CA 92553-5920
(951) 924-9931
(951) 243-8126
Mailing address
23110 ATLANTIC CIR, SUITE A, MORENO VALLEY, CA 92553-5920
(951) 924-9931
(951) 243-8126
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
17311
CA
Other
Enumeration date
07/14/2008
Last updated
07/14/2008
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