Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Daniel Larson, PA-C

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1174084149

Jacob Daniel Larson, PA-C is a Physician Assistant in San Diego, California. Qualified in 2020, 6 years ago. Practices with Robert Marriott Medical Corp, a 64-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
6
Licensed in
CA
In the registry since
2019
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

San Diego, CA

No coordinates on file. Search this address in Google Maps

Additional practice locations (1)

  • 7450 Olivetas Ave, La Jolla, CA 92037-4900 — (858) 454-4201

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 58776 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (CA)
Physician Assistant Taxonomy 363A00000X · Licence PA58776 (CA)

Record details

NPI number1174084149
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 30, 2019
Last updated in NPPESMay 6, 2025
Certification dateMay 6, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Robert Marriott Medical Corp — 64 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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