Individual provider Active NPI

Steven Edwin Larson, MD

  • Infectious Disease Physician
  • Riverside, CA
National Provider Identifier
1790766160
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
G41825 Issued in CA
Practice address
7117 Brockton Ave
Riverside, CA 92506-2615
Phone
(951) 782-3618
Fax
(951) 784-3272
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G41825 CA
Infectious Disease Physician 207RI0200X G41825 CA Primary

Addresses

Primary practice location

7117 Brockton Ave
Riverside, CA 92506-2615

Mailing address

3660 Arlington Ave
Riverside, CA 92506-3912
Phone (951) 782-5110

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ31887ZOtherGROUP SITE NUMBER
1730180415OtherGROUP NPI

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
I20081210000593 CA Practitioner - Internal Medicine 2466521083 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41825CAMDDentist
G41825CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Medical Clinic, Inc Internal Medicine CurrentSince Jun 9, 2007 Accepting new patients
Riverside Medical Clinic, Inc Current Accepting new patients

Locations

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1790766160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 ARLINGTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063912",
            "telephone_number": "951-782-5110",
            "fax_number": "951-274-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062615",
            "telephone_number": "951-782-3618",
            "fax_number": "951-784-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "STEVEN",
        "middle_name": "EDWIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G41825",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "G41825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP SITE NUMBER",
            "identifier": "ZZZ31887Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1730180415",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.