Individual provider Active NPI

Larry Allan Freeman, M.D.

  • Family Medicine Physician
  • Palo Alto, CA
National Provider Identifier
1871629568
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A25347 Issued in CA
Practice address
4161 El Camino Way Ste a
Palo Alto, CA 94306-4084
Phone
(650) 493-2022
Fax
(650) 493-6022
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X A25347 CA
Family Medicine Physician 207Q00000X A25347 CA Primary
Sports Medicine (Family Medicine) Physician 207QS0010X A25347 CA
Pain Medicine Physician 208VP0000X A25347 CA

Addresses

Primary practice location

4161 El Camino Way Ste a
Palo Alto, CA 94306-4084

Mailing address

4161 El Camino Way Ste a
Palo Alto, CA 94306-4084
Phone (650) 493-2022

Other identifiers 1

IdentifierTypeStateIssuer
A25347OtherCACA MEDICAL LICENSE #

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
I20100428000764 CA Practitioner - Family PracticePractitioner - Sports MedicinePractitioner - Pain Management 5496882136 Practice locations: Palo Alto, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Irvine, California College of Medicine, 1972
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4161 El Camino Way
Suite a
Palo Alto, CA 94306-4084
Phone (650) 493-2022

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268179200000",
    "number": "1871629568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4161 EL CAMINO WAY STE A",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943064084",
            "telephone_number": "650-493-2022",
            "fax_number": "650-493-6022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4161 EL CAMINO WAY STE A",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943064084",
            "telephone_number": "650-493-2022",
            "fax_number": "650-493-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "LARRY",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2010-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "CA",
            "license": "A25347",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A25347",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "A25347",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "A25347",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE #",
            "identifier": "A25347",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.