Individual
MS. TERESA LYNN LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
18811 HUNTINGTON ST STE 130, HUNTINGTON BEACH, CA 92648-6003
(714) 596-1105
(714) 596-1155
Mailing address
18811 HUNTINGTON ST STE 130, HUNTINGTON BEACH, CA 92648-6003
(714) 596-1105
(714) 596-1155
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 14774
CA
Other
Enumeration date
07/16/2006
Last updated
04/15/2011
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