JEROME WILLIAM LARSON (NPI# 1902242654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902242654 |
| Entity Type | Individual |
| Full Name | JEROME WILLIAM LARSON |
| Credential | M.D. |
| Practice Address |
1983 Marengo St Los Angeles CA 90033-1370 |
| Practice Telephone | 3234097677 |
| Mailing Telephone | 3234097677 |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2019-07-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 125062965 | IL | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | A162079 | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1653 W. Congress Parkway, Rush University Medical Center, Chicago, IL 60612 | 4053970376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063055192 | Jerome Allen Larson | Peer Specialist | 3090 N 53rd St, Milwaukee, WI 53210-1617 | 2019-10-22 |
| Street Address |
1983 MARENGO ST |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90033-1370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578643870 | John Raymond Yuen | Pharmacist | 1983 Marengo St, Radiopharmacy - Lac/usc Medical Center, Los Angeles, CA 90033-1370 | 2006-10-17 |
| 1326648924 | Nnenna Caroline Iheaka | Registered Nurse | 1983 Marengo St, Los Angeles, CA 90033-1370 | 2020-11-01 |
| 1609496736 | Sinat Oyinkansola Aleje | Nurse Practitioner | 1983 Marengo St, Los Angeles, CA 90033-1370 | 2020-04-18 |
| 1841841368 | Jennifer Brizuela | Social Worker | 1983 Marengo St, Los Angeles, CA 90033-1370 | 2019-09-25 |
| 1902302318 | Charlton Ong | Student in an Organized Health Care Education/Training Program | 1983 Marengo St, D&t 3d321, Los Angeles, CA 90033 | 2018-04-04 |
| 1659872802 | Paul Triamarit | Nurse Practitioner | 1983 Marengo St, Los Angeles, CA 90033-1370 | 2018-02-23 |
| 1174040216 | Darren J May | Respiratory Therapist, Registered | 1983 Marengo St, Los Angeles, CA 90033-1370 | 2017-08-29 |
| 1205353737 | Jungyee Heo Park | Registered Nurse | 1983 Marengo St, Los Angeles, CA 90033-1370 | 2017-08-25 |
| 1255858700 | Susan Tang | Registered Nurse | 1983 Marengo St, Los Angeles, CA 90033-1370 | 2017-08-25 |
| 1699292086 | Yan Chen | Registered Nurse | 1983 Marengo St, Los Angeles, CA 90033-1370 | 2017-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376165050 | Noa Yee | Student in an Organized Health Care Education/Training Program | 1200 N. State Street, Gnh 1011, Los Angeles, CA 90033 | 2020-05-15 |
| 1629690144 | Monica Lopez | Respiratory Therapist, Registered | 1251 Marengo St, Los Angeles, CA 90033 | 2020-05-07 |
| 1649890401 | Antonio Hernandez Saenz | Student in an Organized Health Care Education/Training Program | 1200 N. State Street Gnh 1060k, Los Angeles, CA 90033 | 2020-04-22 |
| 1417585100 | Kelsey Grace Shea | Student in an Organized Health Care Education/Training Program | 1200 N State St Ird 112, Los Angeles, CA 90033 | 2020-03-30 |
| 1891322780 | Carolyn Kan | Student in an Organized Health Care Education/Training Program | 1200 North State Street Clinic Tower, Suite A7d, Los Angeles, CA 90033 | 2020-03-23 |
| 1902445786 | Maury M Hopkins | Registered Nurse | 1883 Marengo Street, Los Angeles, CA 90033 | 2019-12-27 |
| 1982259792 | Beverly Austin Mccabe | Registered Nurse | 1720 E. Cesar Chavez Ave., Los Angeles, CA 90033 | 2019-08-08 |
| 1093369399 | Christine Yoon | Pharmacist | 1611 E Cesar Chavez Ave, Los Angeles, CA 90033 | 2019-07-25 |
| 1073075339 | Johanna Keller | Student in an Organized Health Care Education/Training Program | La County +usc Medical Center, 2051 Marengo Street, Los Angeles, CA 90033 | 2019-04-04 |
| 1386115137 | Sonya Lorain Earley | Physician Assistant | 2020 Zonal Avenue, Ird 626, Los Angeles, CA 90033 | 2018-12-05 |
| Find all providers in zip 90033 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1609403807 | Doctors On The Go Professional Group Corp. | General Practice | 3325 Wilshire Blvd Ste 210, Los Angeles, CA 90010-1718 | 2020-03-26 |
| 1568001584 | Ahdout Health Services, Inc. | General Practice | 2121 Avenue of The Stars # Ll20, Los Angeles, CA 90067-5010 | 2019-12-23 |
| 1104470384 | Chan Family Medical Corp | General Practice | 4070 E. Olympic Blvd, Los Angeles, CA 90023 | 2019-07-26 |
| 1972064004 | Divine Help Medical Group Inc | General Practice | 1711 W Temple St Unit 5613, Los Angeles, CA 90026-5421 | 2019-03-29 |
| 1942767801 | Plaza Health Services Inc. | General Practice | 11111 Santa Monica Blvd Ste 200, Los Angeles, CA 90025-3333 | 2019-02-27 |
| 1124536289 | Edward Meltser | General Practice | 469 N Alfred St, Los Angeles, CA 90048-2504 | 2018-01-11 |
| 1023524980 | St. Johns Urgent Care & Medical Corporation | General Practice | 1138 N Western Ave, Los Angeles, CA 90029-1702 | 2017-12-14 |
| 1992234199 | David Ghods | General Practice | 3631 Crenshaw Blvd Ste 109, Los Angeles, CA 90016-4869 | 2017-06-09 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90033 |
Please comment or provide details below to improve the information on JEROME WILLIAM LARSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.