Healthcare Provider Details

I. General information

NPI: 1821164591
Provider Name (Legal Business Name): PHILIP LARKINS, DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 E PENNSYLVANIA AVE STE H
ESCONDIDO CA
92025-3432
US

IV. Provider business mailing address

925 E PENNSYLVANIA AVE STE H
ESCONDIDO CA
92025-3432
US

V. Phone/Fax

Practice location:
  • Phone: 760-741-1005
  • Fax: 760-741-1032
Mailing address:
  • Phone: 760-741-1005
  • Fax: 760-741-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberE4457
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberE4457
License Number StateCA

VIII. Authorized Official

Name: DR. PHILIP EDWARD LARKINS
Title or Position: OWNER & PROVIDER
Credential: D.P.M.
Phone: 760-741-1005