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1487334843
JONATHAN LARSON MD PC
SAN CLEMENTE, CA
NPI
1487334843
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Entity Type
Organization
Authorized Contact
JOSHUA HOST
Authorized Official
949-484-9517
Organization Subpart ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
Enumeration Date
2023-07-20
Last Update Date
2024-08-26
Business Address
JONATHAN LARSON MD PC
2719 S EL CAMINO REAL
SAN CLEMENTE, CA 92672-3354
Phone number: 949-484-9517
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Mailing Address
JONATHAN LARSON MD PC
2505 ANTHEM VILLAGE DRIVE SUITE F #162
HENDERSON, NV 89052
Phone number: 949-484-9517
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