Provider Demographics
NPI:1447461637
Name:LARSON, SUSAN PIROS (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:PIROS
Last Name:LARSON
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:MISS
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:PIROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:4148 CASTERSON CT
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7534
Mailing Address - Country:US
Mailing Address - Phone:650-954-0044
Mailing Address - Fax:650-649-2214
Practice Address - Street 1:1020 SERPENTINE LN STE 115
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-4758
Practice Address - Country:US
Practice Address - Phone:650-954-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-27
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1156792083X0100X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine