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LARRY I. EMDUR, D.O., PHD.
NPI 1326189671
Specialist in San Diego, CA

Active since February 09, 2007
5555 RESERVOIR DR, 201, SAN DIEGO, CA 92120(619) 286-8803(619) 286-2344 Get Directions Write a Review

NPPES record last updated: August 6, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Larry I. Emdur, D.o., Phd. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LARRY I. EMDUR, D.O., PHD. (NPI 1326189671) is a healthcare organization registered as a specialist in San Diego, California and active in the NPI registry since February 2007. The organization lists Larry I Emdur, President,owner, as its authorized official.

NPPES Registry Identity

NPI1326189671
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameLARRY I. EMDUR, D.O., PHD.
Location Address5555 RESERVOIR DR, 201San Diego, CA 92120-5134
Mailing Address5173 Waring Rd, Suite 125San Diego, CA 92120-2705 · (619) 286-8803 · Fax (619) 286-2344
Phone(619) 286-8803
Fax(619) 286-2344
Organization SubpartNo
Authorized OfficialLarry I EmdurPresident,owner · (619) 286-8803
Enumeration DateFebruary 9, 2007
Last NPPES UpdateAugust 6, 2012
✔ NPI 1326189671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CA · 20A4940
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
5555 RESERVOIR DR, San Diego, CA 92120
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Other Identifiers 4

Other20A4940CA · Ca State License
Medicare UPINA93600CA
Medicare PINW10998CA
OtherGR0044140CA · Medi-ca;

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Larry I. Emdur, D.o., Phd. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Larry I. Emdur, D.O., Phd., which bills Medicare for the services this clinician delivers.

Clinician (1)

Larry Emdur, DO, PHD
Critical Care (Intensivists)
NPI 1932109642
6719 ALVARADO RD #108
San Diego, CA 92120
(619) 286-8803
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Larry I. Emdur, D.O., Phd.'s NPI number?

The NPI number for Larry I. Emdur, D.O., Phd. is 1326189671. It was assigned to this organization in the NPPES registry on February 9, 2007.

Where is Larry I. Emdur, D.O., Phd. located?

Larry I. Emdur, D.O., Phd. is located at 5555 Reservoir Dr 201, San Diego, CA 92120. The listed phone number is (619) 286-8803.

What is Larry I. Emdur, D.O., Phd.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Larry I. Emdur, D.O., Phd. enrolled in Medicare?

Yes. Larry I. Emdur, D.O., Phd. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Larry I. Emdur, D.O., Phd.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Critical Care (Intensivists)) reassigns their Medicare billing to Larry I. Emdur, D.O., Phd.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Larry I. Emdur, D.O., Phd. was last updated on August 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.