Provider Demographics
NPI:1588820955
Name:LARSON, SARAH MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MARIE
Last Name:LARSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10833 LE CONTE AVE
Mailing Address - Street 2:42-121 CHS
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1447
Mailing Address - Country:US
Mailing Address - Phone:310-825-7768
Mailing Address - Fax:310-206-5511
Practice Address - Street 1:10833 LE CONTE AVE
Practice Address - Street 2:42-121 CHS
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-1447
Practice Address - Country:US
Practice Address - Phone:310-825-7768
Practice Address - Fax:310-206-5511
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA117249207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHK136ZMedicare PIN