Individual
LATISA S CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
891 KUHN DR STE 111, CHULA VISTA, CA 91914
(619) 475-9744
(619) 475-4450
Mailing address
891 KUHN DR STE 111, CHULA VISTA, CA 91914-3551
(619) 475-9744
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A72235
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A722350
—
CA
Enumeration date
10/13/2005
Last updated
08/29/2018
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