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Organization

MITCHELL C LATTER MD INC A PROF CORP

Active
Other names
Mitchell C Latter MD Inc
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MITCHELL CURTIS LATTER MD (PRESIDENT)
(626) 799-9588
Entity
Organization

Contact information

Practice address
1499 HUNTINGTON DRIVE, SUITE 508, SOUTH PASADENA, CA 91030-5464
(626) 799-9588
(626) 799-9339
Mailing address
1499 HUNTINGTON DRIVE, SUITE 508, SOUTH PASADENA, CA 91030-5464
(626) 799-9588
(626) 799-9339

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
G40013
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G400131
CA
01
1255411625
NPI TYPE 1
CA
Enumeration date
03/27/2007
Last updated
12/09/2011
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