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NPI Code Detail

MEDICARE: DR. LARRY TYRON GAINES M.D.

MEDICARE: DR. LARRY TYRON GAINES M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0402XNeurology with Special Qualifications in Child Neurology Physician036135642CA

General Provider Information

NPI Number : 1427287903
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRY TYRON GAINES M.D.
Provider Business Mailing Address
First Line : 510 PLAZA DR STE 170
Second Line :
City : FOLSOM
State : CA
Zip : 95630-4790
Country : US
Telephone Number : 916-351-9400
Fax Number : 916-351-9449
Provider Business Practice Location Address
First Line : 510 PLAZA DR STE 170
Second Line :
City : FOLSOM
State : CA
Zip : 95630-4790
Country : US
Telephone Number : 916-351-9400
Fax Number : 916-351-9449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2009
Last Update Date : 04/14/2026

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