Individual
LAITH MOHAMMAD ALI ALTAMIMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
5345 W HILLSDALE AVE, VISALIA, CA 93291-5143
(596) 220-1005
(559) 622-0700
Mailing address
PO BOX 7058, VISALIA, CA 93290-7058
(559) 622-0100
(559) 622-0700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95010887
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95010887
NP
CA
Enumeration date
08/30/2017
Last updated
09/20/2019
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