Individual provider Active NPI

Annie Ngo Larrow, M.D.

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1417344128
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A147181 Issued in CA
Practice address
7910 Frost St Ste 280
San Diego, CA 92123-2752
Phone
(858) 496-4800
Fax
(858) 496-4850
NPI assigned
Apr 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A147181 CA Primary

Addresses

Primary practice location

7910 Frost St Ste 280
San Diego, CA 92123-2752

Mailing address

7910 Frost St Ste 280
San Diego, CA 92123-2752
Phone (858) 496-4800

Other practice location 1

3020 Childrens Way
San Diego, CA 92123-4223
Phone (858) 966-5841

Other names 1

  • Annie Ngo Tan Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200929003269 CA Practitioner - Pediatric Medicine 2567881246 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A147181CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Sep 23, 2020 Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Sep 23, 2020 Accepting new patients
Rady Children'S Hospital San Diego CurrentSince Dec 8, 2020 Accepting new patients
Rady Children'S Hospital San Diego Pediatrics CurrentSince Dec 8, 2020 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients

Locations

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

3020 Childrens Way
#5124
San Diego, CA 92123
Phone (858) 966-6764

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

4725 Market St
San Diego, CA 92102
Phone (619) 515-2560

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

7910 Frost St
Ste 280
San Diego, CA 92123
Phone (619) 398-2988

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1417344128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7910 FROST ST STE 280",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232752",
            "telephone_number": "858-496-4800",
            "fax_number": "858-496-4850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 FROST ST STE 280",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232752",
            "telephone_number": "858-496-4800",
            "fax_number": "858-496-4850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3020 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234223",
            "country_code": "US",
            "telephone_number": "858-966-5841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARROW",
        "first_name": "ANNIE",
        "middle_name": "NGO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A147181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNIE",
            "last_name": "TAN",
            "middle_name": "NGO",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.