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General NPI Number Information
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NPI Number | 1386777084
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Entity Type | Individual
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Provider Name | LARRY PICARD DDS
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 11500 W OLYMPIC BLVD SUIT 326
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City | LOS ANGELES
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State | CA
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Zip | 90064-1524
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Country | US
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Telephone | 310-479-4500
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Fax | 310-479-4200
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Provider Business Mailing Address
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Address Line | 3730 CROWNRIDGE DR
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-4819
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Country | US
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Telephone | 818-986-9915
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 34404
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License Number State | CA
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