Provider Demographics
NPI:1821164591
Name:PHILIP LARKINS, DPM
Entity Type:Organization
Organization Name:PHILIP LARKINS, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:LARKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:760-741-1005
Mailing Address - Street 1:925 E PENNSYLVANIA AVE
Mailing Address - Street 2:STE H
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3432
Mailing Address - Country:US
Mailing Address - Phone:760-741-1005
Mailing Address - Fax:760-741-1032
Practice Address - Street 1:925 E PENNSYLVANIA AVE
Practice Address - Street 2:STE H
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3432
Practice Address - Country:US
Practice Address - Phone:760-741-1005
Practice Address - Fax:760-741-1032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4457332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU94473Medicare UPIN
CAE4457Medicare ID - Type UnspecifiedPROVIDER NUMBER
CA4822500002Medicare NSC