Healthcare Provider Details

I. General information

NPI: 1740390616
Provider Name (Legal Business Name): LARRY EVERETT NORTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

473 CABRILLO ST SUITE A1A
MONTEREY CA
93944-3201
US

IV. Provider business mailing address

PO BOX 51128
PACIFIC GROVE CA
93950-6128
US

V. Phone/Fax

Practice location:
  • Phone: 831-242-5741
  • Fax: 831-242-6719
Mailing address:
  • Phone: 831-643-9921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number038663
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: