Active NPI
Spencer Larsen Jr., M.D.
- Health Service Clinic/Center
- Danville, CA
National Provider Identifier
1114471620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- License
- G-17623
- Practice address
- 70 Princeton CT
Danville, CA 94526-4122 - Phone
- (925) 837-1683
- NPI assigned
- Aug 12, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | G-17623 | CA | Primary |
Addresses
Primary practice location
70 Princeton CT
Danville, CA 94526-4122
Mailing address
70 Princeton CT
Danville, CA 94526-4122
Phone (925) 837-1683
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G-17623 | CA | MD | Health Service Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470960000000",
"number": "1114471620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 PRINCETON CT",
"city": "DANVILLE",
"state": "CA",
"postal_code": "945264122",
"telephone_number": "925-837-1683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 PRINCETON CT",
"city": "DANVILLE",
"state": "CA",
"postal_code": "945264122",
"telephone_number": "925-837-1683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "SPENCER",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-12",
"last_updated": "2016-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": "CA",
"license": "G-17623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.