Most Relevant Information
Provider Data
| NPI Number: | 1003599465 |
| Provider Name: | MADELYN LARSON |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/10/2023 |
| Last Updated: | 08/10/2023 |
Provider Practice Location
6246 MORNINGSIDE DR
HUNTINGTON BEACH
CA
926486102
Practice Location Phone/Fax
| Phone: | 5622379259 |
| Fax: |
Provider Mailing Location
6246 MORNINGSIDE DR
HUNTINGTON BEACH
CA
926486102
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |