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Organization

BRUCE V LATTYAK M.D., INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRUCE V LATTYAK MD (OWNER)
(530) 477-1199
Entity
Organization

Contact information

Practice address
300 SIERRA COLLEGE DR STE 240, GRASS VALLEY, CA 95945-5086
(530) 273-3400
(530) 274-3400
Mailing address
300 SIERRA COLLEGE DR STE 240, GRASS VALLEY, CA 95945-5086
(530) 273-3400
(530) 274-3400

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
A62583
CA
208200000X
Plastic Surgery Physician
Primary
A62583
CA

Other

Enumeration date
04/18/2008
Last updated
08/29/2019
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