JEROME WILLIAM LARSON M.D. NPI 1902242654

NPI Information

NPI: 1902242654
Provider Name: JEROME WILLIAM LARSON, M.D.
Classification: General Practice - 208D00000X
Entity Type: Individual
Organization: RADIOLOGY CONSULTANTS OF TULSA, INC.

PECOS Registration: Yes

Address:
1983 MARENGO ST
LOS ANGELES, CA
ZIP 90033
Phone: (323) 409-7677
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Jerome William Larson, M.D. is a general practice in Los Angeles, CA with 11 years of experience. Jerome William Larson, M.D. NPI is 1902242654. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Graduation Year:2013

The provider's business location address is:

1983 MARENGO ST
LOS ANGELES, CA
ZIP 90033-370
Phone: (323) 409-7677

The NPI 1902242654 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/21/2013 and was last updated on 7/23/2019.

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	208600000X	Surgery		125062965	ILLINOIS	No
2	208D00000X	General Practice		A162079	CALIFORNIA	Yes

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: 11/14/2023

NPI Synchronization or Removal

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