Provider Demographics
NPI:1417344128
Name:LARROW, ANNIE NGO (MD)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:NGO
Last Name:LARROW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:NGO
Other - Last Name:TAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7910 FROST ST STE 280
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2752
Mailing Address - Country:US
Mailing Address - Phone:858-496-4800
Mailing Address - Fax:858-496-4850
Practice Address - Street 1:7910 FROST ST STE 280
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2752
Practice Address - Country:US
Practice Address - Phone:858-496-4800
Practice Address - Fax:858-496-4850
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA147181208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program