Provider Demographics
NPI:1073525564
Name:STRIEFF, LARRY (MD)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:
Last Name:STRIEFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 TELEGRAPH AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-1743
Mailing Address - Country:US
Mailing Address - Phone:510-830-3100
Mailing Address - Fax:510-830-3316
Practice Address - Street 1:2633 TELEGRAPH AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1743
Practice Address - Country:US
Practice Address - Phone:510-830-3100
Practice Address - Fax:510-830-3316
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC31515207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C315150Medicaid
CA00C315150Medicare ID - Type Unspecified
CAA34598Medicare UPIN