Corey B. Larsen, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G21579 Issued in CA

Practice address

30745 Pacific Coast Hwy # 439
Malibu, CA 90265-3647

Phone

(310) 874-0440

NPI assigned

Nov 8, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1437339264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11999 SAN VICENTE BLVD STE 440",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495042",
            "telephone_number": "310-471-5852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30745 PACIFIC COAST HWY # 439",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902653647",
            "telephone_number": "310-874-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "COREY",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G21579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G215790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nicole Mariko Elby Lee, PT,DPT,SCS,ATC,CSCS
• Leisure Living, Inc.
• Justin J. Leitstein, LMFT
• Justin Letzt, DC

• Anesthesiology Physician in Malibu, CA
• Providers in Malibu, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.