Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 7048 TPL | CA |
NPI | 1033269063 |
---|---|
Provider Name | Dr. Larry Alan Sarver |
First Address | Oakland, CA 94618-1416 |
Second Address | Oakland, CA 94618-1416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 07/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
SD0070480 | (05) | CA |
T10461 | (02) | CA |