MEDICARE: ANNIE NGO LARROW M.D.

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	208000000X	Pediatrics Physician	A147181	CA

General Provider Information

NPI Number	:	1417344128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNIE NGO LARROW M.D.

Provider Business Mailing Address
First Line	:	7910 FROST ST STE 280
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-2752
Country	:	US
Telephone Number	:	858-496-4800
Fax Number	:	858-496-4850

Provider Business Practice Location Address
First Line	:	7910 FROST ST STE 280
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-2752
Country	:	US
Telephone Number	:	858-496-4800
Fax Number	:	858-496-4850

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

Provider Enumeration Date	:	04/20/2015
Last Update Date	:	12/04/2020

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