| Doctor Name: | DR. LARRY JOHN BIEDERMAN |
| NPI Number: | 1952642100 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M. |
| License Number: | E1966 |
| Business Practice Address: | 859 Sandalwood Dr Lake Arrowhead, CA - 92352 |
| Business Phone Number: | 9093376299 |
| Business Fax Number: | 9095224307 |
| Mailing Address: | Po Box 2233, BLUE JAY |
| State: | CA |
| Postal Code: | 923172233 |
| Phone Number: | 9093376299 |
| Fax Number: | 9095224307 |
| NPI Enumeration Date: | 03/13/2013 |
| NPI Last Update Date: | 03/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | E1966 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |