Healthcare Provider Details

I. General information

NPI: 1659375103
Provider Name (Legal Business Name): PHILIP EDWARD LARKINS D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 N ELM ST
ESCONDIDO CA
92025-3002
US

IV. Provider business mailing address

937 PASEO LA CRESTA
CHULA VISTA CA
91910-6729
US

V. Phone/Fax

Practice location:
  • Phone: 833-867-4642
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE4457
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4457
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: