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General NPI Number Information
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NPI Number | 1285801548
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Entity Type | Individual
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Provider Name | MR. LARRY A. EDWARDS
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Gender | Male
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 05/14/2008
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Provider Practice Location Address
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Address Line | 1190 MARKET ST SUITE D
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City | YUBA CITY
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State | CA
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Zip | 95991-3451
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Country | US
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Telephone | 530-713-4305
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Fax | 530-674-5994
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Provider Business Mailing Address
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Address Line | 1190 MARKET ST SUITE D
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City | YUBA CITY
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State | CA
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Zip | 95991-3451
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Country | US
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Telephone | 530-713-4305
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Fax | 530-674-5994
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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