Individual
SHAHID LATIF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18280 SISKIYOU RD, APPLE VALLEY, CA 92307-1413
(760) 242-9999
(760) 242-1121
Mailing address
104 WOODMONT BLVD STE 500, NASHVILLE, TN 37205-2245
(562) 492-6695
(562) 988-0389
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
30940
AZ
2085R0001X
Radiation Oncology Physician
Primary
C129435
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
745763
—
AZ
01
—
777903
WELLCARE MEDICARE ADVANTAGE
AZ
01
—
AZ0727110
BCBS
AZ
Enumeration date
05/22/2006
Last updated
04/04/2023
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