Provider Demographics
NPI:1861626608
Name:LARIOS, TOSHA A (DPM)
Entity Type:Individual
Prefix:
First Name:TOSHA
Middle Name:A
Last Name:LARIOS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:TOSHA
Other - Middle Name:A
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:965 SUTTER ST
Mailing Address - Street 2:APT 307
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-6068
Mailing Address - Country:US
Mailing Address - Phone:928-925-7194
Mailing Address - Fax:
Practice Address - Street 1:3198 N WINDSONG DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-2239
Practice Address - Country:US
Practice Address - Phone:928-925-7194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ0684213ES0103X
NM322213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery