LARRY CHARLES HICKS PA NPI 1568453801

NPI Information

NPI: 1568453801
Provider Name: LARRY CHARLES HICKS, PA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
1441 FLORIDA
MODESTO, CA
ZIP 95352
Phone: (209) 576-3999
Get Directions

Larry Charles Hicks, PA is a surgical physician assistant in Modesto, CA. Larry Charles Hicks, PA NPI is 1568453801. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1441 FLORIDA
MODESTO, CA
ZIP 95352
Phone: (209) 576-3999

The enumeration date for this NPI number is 11/4/2005 and was last updated on 1/11/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0PA108441	MEDICARE PIN	CALIFORNIA
2	OPA108440	OTHER	CALIFORNIA	BLUE SHIELD
3	P27573	MEDICARE UPIN
4	CD069A	OTHER	CALIFORNIA	GROUP PTAN
5	0PA108440	MEDICARE PIN	CALIFORNIA
6	OPA108440	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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