Individual
GRACE G LAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6599 FOOTHILL BLVD., OAKLAND, CA 94605
(510) 567-5700
Mailing address
2709 CHERRY BLOSSOM WAY, UNION CITY, CA 94587-4911
(510) 429-0933
(510) 429-0960
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
A5590
CA
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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