Most Relevant Information
Provider Data
| NPI Number: | 1003058504 |
| Provider Name: | PAUL R LARSEN |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/30/2009 |
| Last Updated: | 03/30/2009 |
Provider Practice Location
327 COLLEGE AVE
SANTA ROSA
CA
954015117
Practice Location Phone/Fax
| Phone: | 7075682800 |
| Fax: | 7075682804 |
Provider Mailing Location
327 COLLEGE AVE.
SANTA ROSA
CA
95401
Provider Mailing Phone/Fax
| Phone: | 7075682800 |
| Fax: | 7075682804 |