Healthcare Provider Details

I. General information

NPI: 1932536802
Provider Name (Legal Business Name): LAARNI GUTIERREZ-DARVIN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2013
Last Update Date: 10/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4566 FLORENCE AVE
CUDAHY CA
90201-4345
US

IV. Provider business mailing address

4566 FLORENCE AVE
CUDAHY CA
90201-4345
US

V. Phone/Fax

Practice location:
  • Phone: 323-771-1433
  • Fax: 323-771-7651
Mailing address:
  • Phone: 323-771-1433
  • Fax: 323-771-7651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA98770
License Number StateCA

VIII. Authorized Official

Name: LAARNI DARVIN
Title or Position: PRESIDENT
Credential: MD
Phone: 323-771-1433