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General NPI Number Information
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NPI Number | 1558703363
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Entity Type | Individual
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Provider Name | KRISZTINA ILONA LARSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/22/2013
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 181 S BUENA VISTA ST FL 4
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City | BURBANK
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State | CA
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Zip | 91505-4504
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Country | US
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Telephone | 818-840-0921
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Fax | 818-840-7064
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Provider Business Mailing Address
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Address Line | 541 W COLORADO ST STE 205
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City | GLENDALE
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State | CA
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Zip | 91204-3640
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Country | US
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Telephone | 323-254-0046
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Fax | 323-488-9782
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | A158003
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License Number State | CA
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