Basic Information
| Provider Information | |||||||||
| NPI: | 1811906753 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARBAR | ||||||||
| FirstName: | LARISA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1682 | ||||||||
| Address2: | |||||||||
| City: | BELLFLOWER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907071682 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5622299452 | ||||||||
| FaxNumber: | 5629204642 | ||||||||
| Practice Location | |||||||||
| Address1: | 2220 CLARK AVE | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908152521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5625974181 | ||||||||
| FaxNumber: | 5625977083 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2006 | ||||||||
| LastUpdateDate: | 02/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 02/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A71864 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | A71864 | CA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 00A718640 | 01 | CA | BLUE SHIELD | OTHER |