Active NPI
Lucy Kaiser Larson, M.D.
- Pediatrics Physician
- Malibu, CA
National Provider Identifier
1295865160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G62764
- Practice address
- 24255 Pacific Coast Hwy
Pepperdine Student Health Center
Malibu, CA 90263-3999 - Phone
- (310) 506-4316
- Fax
- (310) 506-4588
- NPI assigned
- Mar 7, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G62764 | CA | Primary |
Addresses
Primary practice location
24255 Pacific Coast Hwy
Pepperdine Student Health Center
Malibu, CA 90263-3999
Mailing address
24255 Pacific Coast Hwy
Pepperdine Student Health Center
Malibu, CA 90263-3999
Phone (310) 506-4316
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 |
|---|---|---|---|
| G62764 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295865160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24255 PACIFIC COAST HWY",
"address_2": "PEPPERDINE STUDENT HEALTH CENTER",
"city": "MALIBU",
"state": "CA",
"postal_code": "902633999",
"telephone_number": "310-506-4316",
"fax_number": "310-506-4588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24255 PACIFIC COAST HWY",
"address_2": "PEPPERDINE STUDENT HEALTH CENTER",
"city": "MALIBU",
"state": "CA",
"postal_code": "902633999",
"telephone_number": "310-506-4316",
"fax_number": "310-506-4588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "LUCY",
"middle_name": "KAISER",
"name_prefix": "Ms.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G62764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malibu, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.