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General NPI Number Information
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NPI Number | 1447461637
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Entity Type | Individual
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Provider Name | SUSAN PIROS LARSON MD, MPH
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Gender | Female
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Dates
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Enumeration Date | 05/27/2007
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Last Update Date | 05/06/2020
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Provider Practice Location Address
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Address Line | 1020 SERPENTINE LN STE 115
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City | PLEASANTON
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State | CA
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Zip | 94566-4758
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Country | US
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Telephone | 650-954-0044
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Fax |
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Provider Business Mailing Address
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Address Line | 4148 CASTERSON CT
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City | PLEASANTON
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State | CA
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Zip | 94566-7534
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Country | US
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Telephone | 650-954-0044
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Fax | 650-649-2214
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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 | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | A115679
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A115679
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License Number State | CA
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