MEDICARE: RAYMOND ANTHONY LAREZ JR. MD MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	390200000X	Student in an Organized Health Care Education/Training Program		CA
3	207Q00000X	Family Medicine Physician	A205102	CA

General Provider Information

NPI Number	:	1275236085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYMOND ANTHONY LAREZ JR. MD MPH

Provider Business Mailing Address
First Line	:	975 SERENO DR
Second Line	:
City	:	VALLEJO
State	:	CA
Zip	:	94589-2441
Country	:	US
Telephone Number	:	707-651-4071
Fax Number	:

Provider Business Practice Location Address
First Line	:	975 SERENO DR
Second Line	:
City	:	VALLEJO
State	:	CA
Zip	:	94589-2441
Country	:	US
Telephone Number	:	707-651-4071
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2023
Last Update Date	:	12/10/2025

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