David R Larson (NPI# 1922448158, PAC ID# 7719270263) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PODIATRY.
| Nation Provider ID (NPI) | 1922448158 |
| PAC ID by PECOS | 7719270263 |
| Professional Enrollment ID | I20170804003405 |
| Full Name | David R Larson |
| Organization Legal Name | PHYSICIAN GROUP OF ARIZONA INC |
| Address |
11851 N 51st Ave Bldg D Suite 120 130 Glendale AZ 85304-2809 |
| Phone Number | 4805050755 |
| Gender | M |
| Graduation Year | 2013 |
| Primary Specialty | PODIATRY |
| Group Practice PAC ID | 1456439967 |
| Number of Group Practice Members | 63 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 030121 | MOUNTAIN VISTA MEDICAL CENTER, LP |
| Address | Phone | Organization |
|---|---|---|
| 11851 N 51st Ave, Bldg D Suite 120 130, Glendale, AZ 85304-2809 | 4805050755 | PHYSICIAN GROUP OF ARIZONA INC |
| Organization Legal Name | PHYSICIAN GROUP OF ARIZONA INC |
| Physicians | 82 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Timothy Kavanaugh | Orthopedic Surgery | Physician Group of Arizona Inc | 230 S 3rd St, Phoenix, AZ 85004-2697 |
| Wesley D High | General Surgery | Physician Group of Arizona Inc | 10238 E Hampton Ave, Mesa, AZ 85209-3322 |
| Leah C Brown | Orthopedic Surgery | Physician Group of Arizona Inc | 1492 S Mill Ave, Suite 113, Tempe, AZ 85281-5660 |
| Andrew R Adamson | Obstetrics/gynecology | Physician Group of Arizona Inc | 455 E 6th St, Suite 100, Mesa, AZ 85203-7118 |
| Shannon M Mclean | Physical Therapy | Physician Group of Arizona Inc | 2835 E Brown Rd, Suite 101, Mesa, AZ 85213-5470 |
| Rob Schuster | General Surgery | Physician Group of Arizona Inc | 555 N 18th St, Suite 300, Phoenix, AZ 85006-3759 |
| Raul A Lopez Gonzalez | General Surgery | Physician Group of Arizona Inc | 2122 E Highland Ave, Suite 300, Phoenix, AZ 85016-4744 |
| Daniel T Fang | General Surgery | Physician Group of Arizona Inc | 2122 E Highland Ave, Suite 300, Phoenix, AZ 85016-4744 |
| Patricia T Mayborne | Nurse Practitioner | Physician Group of Arizona Inc | 1301 S Crimson Rd, Mesa, AZ 85209-3767 |
| James A Taylor Jr. | General Surgery | Physician Group of Arizona Inc | 10238 E Hampton Ave, Suite 301a, Mesa, AZ 85209-3322 |
| Street Address |
11851 N 51ST AVE BLDG D SUITE 120 130 |
| City | GLENDALE |
| State | AZ |
| Zip | 85304-2809 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Heather Castonguay | Clinical Social Worker | Neighborhood Outreach Access To Health | 11851 N 51st Ave, Bldg B, Glendale, AZ 85304-2809 |
| Kathy N Vu | Optometry | 11851 N 51st Ave, Bldg A Suite 120, Glendale, AZ 85304-2830 | |
| Zachary A Flynn | Podiatry | Physician Group of Arizona Inc | 11851 N 51st Ave, Bldg D Suite 120 130, Glendale, AZ 85304-2809 |
| Laura A Truax | Physician Assistant | Joel S Sellers Do LLC | 11851 N 51st Ave, Suite F110, Glendale, AZ 85304-2827 |
| Ryan Martin | Physical Therapy | Joel S Sellers Do LLC | 11851 N 51st Ave, Suite F110, Glendale, AZ 85304-2827 |
| Ronald S Burns | Anesthesiology | Serenity Anesthesia LLC | 11851 N 51st Ave, Suite F140, Glendale, AZ 85304-2847 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Young W Kahn | Physical Medicine and Rehabilitation | 13460 N 67th Ave, Glendale, AZ 85304-1000 | |
| Christopher P Barnes | Physical Medicine and Rehabilitation | 13460 N 67th Ave, Glendale, AZ 85304-1000 | |
| Alison E.f Reuter | Psychologist, Clinical | 13460 N 67th Ave, Healthsouth Valley of The Sun Rehabilitation Hospital, Glendale, AZ 85304-1000 | |
| Michael L Kravetz | Physical Medicine and Rehabilitation | 13460 N 67th Ave, Glendale, AZ 85304-1000 | |
| Harjot Brar | Oral Surgery | 10630 N 59th Ave, Suite 101, Glendale, AZ 85304-1239 | |
| Michael J Bennington | Family Medicine | Cigna Healthcare of Arizona Inc | 5891 W Eugie Ave, Cmg Paseo Urgent Care Cmg Paseo Ahc, Glendale, AZ 85304-1252 |
| Rao R Gudapati | Internal Medicine | Cigna Healthcare of Arizona Inc | 5891 W Eugie Ave, Cmg Paseo Healthcare Center Paseo, Glendale, AZ 85304-1252 |
| Daniel J Weiler | Family Medicine | Cigna Healthcare of Arizona Inc | 5891 W Eugie Ave, Cmg Paseo Urgent Care Cmg Paseo Ahc, Glendale, AZ 85304-1252 |
| May H Mohty | Pediatric Medicine | Cigna Healthcare of Arizona Inc | 5891 W Eugie Ave, Cmg Paseo Urgent Care Cmg Paseo Ahc, Glendale, AZ 85304-1252 |
| Janet D Tate Brown | Nurse Practitioner | Cigna Healthcare of Arizona Inc | 5891 W Eugie Ave, Cmg Paseo Healthcare Center Paseo, Glendale, AZ 85304-1252 |
| Find all physicians in zip 85304 | |||
| City | GLENDALE |
| Zip Code | 85304 |
| Specialty | PODIATRY |
| City + Specialty | GLENDALE + PODIATRY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.