Provider Demographics
NPI:1780605071
Name:LAROSA, JULIUS B (MD)
Entity type:Individual
Prefix:
First Name:JULIUS
Middle Name:B
Last Name:LAROSA
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:PO BOX 33269
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85067-3269
Mailing Address - Country:US
Mailing Address - Phone:602-406-4786
Mailing Address - Fax:916-636-4358
Practice Address - Street 1:1727 W FRYE RD STE 210
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224
Practice Address - Country:US
Practice Address - Phone:480-728-7564
Practice Address - Fax:480-728-2253
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60901048207R00000X
KY40188207R00000X
AZ63353208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000515123OtherANTHEM - NIS
IN200870710Medicaid
WA2120993Medicaid
KY50014983OtherPASSPORT - NIS
KY4811682OtherCIGNA - NIS
KY000023027XOtherHUMANA - NIS
KY00533153OtherMEDICARE - KY - NIS
IN2000870710OtherANTHEM IN
KY64131048Medicaid
KY2846927000OtherPASSPORT ADVANTAGE/NORTON
4844682OtherCIGNA/NORTON
P00439746OtherRAILROAD MEDICARE/NORTON
086116OtherSIHO/NORTON
AZ088346Medicaid