Basic Information
| Provider Information | |||||||||
| NPI: | 1780605071 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAROSA | ||||||||
| FirstName: | JULIUS | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 33269 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850673269 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6024064786 | ||||||||
| FaxNumber: | 9166364358 | ||||||||
| Practice Location | |||||||||
| Address1: | 1727 W FRYE RD STE 210 | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4807287564 | ||||||||
| FaxNumber: | 4807282253 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2006 | ||||||||
| LastUpdateDate: | 07/05/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 40188 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD60901048 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 63353 | AZ | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 000000515123 | 01 | KY | ANTHEM - NIS | OTHER | 200870710 | 05 | IN | MEDICAID | 64131048 | 05 | KY | MEDICAID | 000023027X | 01 | KY | HUMANA - NIS | OTHER | 2120993 | 05 | WA | MEDICAID | 2846927000 | 01 | KY | PASSPORT ADVANTAGE/NORTON | OTHER | P00439746 | 01 | RAILROAD MEDICARE/NORTON | OTHER | 00533153 | 01 | KY | MEDICARE - KY - NIS | OTHER | 086116 | 01 | SIHO/NORTON | OTHER | 4811682 | 01 | KY | CIGNA - NIS | OTHER | 4844682 | 01 | CIGNA/NORTON | OTHER | 2000870710 | 01 | IN | ANTHEM IN | OTHER | 50014983 | 01 | KY | PASSPORT - NIS | OTHER |