Brent Raymond Larson, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A63652 Issued in CA

Practice address

1393 Santa Rita Rd
Suite F
Pleasanton, CA 94566-5665

Phone

(925) 462-2334

Fax

(925) 462-2335

NPI assigned

Jan 24, 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

State licenses

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226880000000",
    "number": "1609921204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "714-347-1012",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1393 SANTA RITA RD",
            "address_2": "SUITE F",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945665665",
            "telephone_number": "925-462-2334",
            "fax_number": "925-462-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "BRENT",
        "middle_name": "RAYMOND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2008-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A63652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A636520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerald Alan Lamberti, DDS MS
• Sunny Landis, COTA/L
• Rosalind Michelle Lane-Williams, PHARMACY TECHNICIAN
• Samuel Lao, DPT
• Catherine Larsen
• Susan Piros Larson, MD, MPH
• Alexandra Danielle Latayan-Pastores
• Juliet Latorre-Olivo
• Amber Lynne Latza, D.C.
• Kai Chung Anderson Lau, PHARM.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; 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.