Larry K Fan, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A73816 Issued in CA

Practice address

77 Van Ness Ave
Suite 302
San Francisco, CA 94102-6041

Phone

(415) 655-7546

Fax

(415) 379-9045

NPI assigned

Jan 3, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lfan183514@hisp.ehr.sutterhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of San Mateo

  • Multi-Specialty Clinic/Center
  • San Mateo, CA
  • NPI 1679642326
  Medicare reassignment NPD
• County of San Mateo

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1528432481
  NPD
• Pacific Specialist Surgical Center LLC

  • Ambulatory Surgical Clinic/Center
  • San Francisco, CA
  • NPI 1508144007
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1316925183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 VAN NESS AVE",
            "address_2": "SUITE 302",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941026041",
            "telephone_number": "415-655-7546",
            "fax_number": "415-379-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 VAN NESS AVE",
            "address_2": "SUITE 302",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941026041",
            "telephone_number": "415-655-7546",
            "fax_number": "415-379-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "LARRY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A73816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Rita Fan
• Jennifer Fan
• Johnny Fan, P.T.
• Joline Fan
• Julie Fan, DTR
• Qin Fan, PSY.D.
• Winnie Fan
• Yuan-Da Fan, M.D.
• Nicole Le Fancher, L.AC.
• Oluwatosin Adebiyi Fancher

• Plastic Surgery Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.