Individual provider Active NPI

Joel Larralde, M.D.

  • Urology Physician
  • San Diego, CA
National Provider Identifier
1952330052
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
G30829 Issued in CA
Practice address
3914 Murphy Canyon Rd
Suite# A206
San Diego, CA 92123-4491
Phone
(858) 974-9766
Fax
(858) 974-9756
NPI assigned
Jul 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X G30829 CA Primary

Addresses

Primary practice location

3914 Murphy Canyon Rd
Suite# A206
San Diego, CA 92123-4491

Mailing address

3914 Murphy Canyon Rd
Suite# A206
San Diego, CA 92123-4491
Phone (858) 974-9755

Other identifiers 1

IdentifierTypeStateIssuer
00G308290MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G30829CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richard C. Richley MD a Professional Medical Corp PastSince Aug 19, 2016 Accepting new patients

Organizations & group practices 1

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": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1952330052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3914 MURPHY CANYON RD",
            "address_2": "SUITE# A206",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234491",
            "telephone_number": "858-974-9755",
            "fax_number": "858-974-9756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3914 MURPHY CANYON RD",
            "address_2": "SUITE# A206",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234491",
            "telephone_number": "858-974-9766",
            "fax_number": "858-974-9756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARRALDE",
        "first_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "G30829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G308290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.