Steven Ray Larsen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT7687T Issued in CA

Practice address

4096 Park Blvd
San Diego, CA 92103-2620

Phone

(619) 291-5505

Fax

(619) 291-4404

NPI assigned

Mar 21, 2007

Last updated

Oct 11, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

State licenses

Practice roles

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

• Uptown Eye Associates a Professional Optometric Corporation

  dba Uptown Optometry

  • Corneal and Contact Management Optometrist
  • San Diego, CA
  • NPI 1689568115
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381449600000",
    "number": "1629194782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4096 CENTRE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032608",
            "telephone_number": "619-291-5505",
            "fax_number": "619-291-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4096 PARK BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032620",
            "telephone_number": "619-291-5505",
            "fax_number": "619-291-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "STEVEN",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2013-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT7687T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0076871",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Kent Larsen, M.A. MFT
• Jennifer Ann Larsen
• Michael Larsen
• Samuel Larsen
• Saturnina Larsen
• Christopher Larson, M.D.
• Christopher Riley Larson
• Courtney Jeanne Larson
• Craig R Larson
• Derek Thomas Larson, D.O.

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2013; 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.