Otwell, Larry Edward
Otwell, Larry Edward is an sole proprietor health care provider with primary practice located at 72840 Ca-111 S Suite F201, Palm Desert CA 92260. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Otwell, Larry Edward can be contacted via phone (760) 848-0040.Contact Information
Primary practice address
72840 Ca-111 S Suite F201
Palm Desert CA 92260
Phone: (760) 848-0040
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1735 | Washington |
Profile Details
| NPI number | 1750487898 |
|---|---|
| LBN Legal business name | Otwell, Larry Edward |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 16th, 2006 |
| Last updated | Feb 27th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750487898 | NPPES |
| Washington | MEDICAID | 2022259 |
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