Healthcare Provider Details

I. General information

NPI: 1528168184
Provider Name (Legal Business Name): STEPHEN LOWMAN LARMORE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 08/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 NORRIS CANYON RD SUITE 302
SAN RAMON CA
94583-5409
US

IV. Provider business mailing address

5401 NORRIS CANYON RD SUITE 302
SAN RAMON CA
94583-5409
US

V. Phone/Fax

Practice location:
  • Phone: 925-277-9000
  • Fax: 925-830-1754
Mailing address:
  • Phone: 925-277-9000
  • Fax: 925-830-1754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberC031854
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: