Healthcare Provider Details

I. General information

NPI: 1851116115
Provider Name (Legal Business Name): JOSHUA T LAARI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2024
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2339 IRVING ST STE 200
SAN FRANCISCO CA
94122-1620
US

IV. Provider business mailing address

2339 IRVING ST STE 200
SAN FRANCISCO CA
94122-1620
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-1591
  • Fax: 972-323-8712
Mailing address:
  • Phone: 415-221-1591
  • Fax: 972-323-8712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: