Provider Demographics
NPI:1043262454
Name:ALB, LARRY ADAM (MD)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:ADAM
Last Name:ALB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 FEATHER RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-4548
Mailing Address - Country:US
Mailing Address - Phone:530-532-8523
Mailing Address - Fax:530-712-2386
Practice Address - Street 1:1611 FEATHER RIVER BLVD
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-4548
Practice Address - Country:US
Practice Address - Phone:530-532-8523
Practice Address - Fax:530-712-2386
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA633322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A633321Medicare ID - Type Unspecified
H33066Medicare UPIN