Provider Demographics
NPI:1033269063
Name:SARVER, LARRY ALAN (OD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:ALAN
Last Name:SARVER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5321 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1416
Mailing Address - Country:US
Mailing Address - Phone:510-655-3797
Mailing Address - Fax:510-655-3701
Practice Address - Street 1:5321 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1416
Practice Address - Country:US
Practice Address - Phone:510-655-3797
Practice Address - Fax:510-655-3701
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7048 TPL152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0070480Medicaid
CAT10461Medicare UPIN
CASD0070480Medicare PIN