Individual
KIRAN LATIF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7965 SIERRA AVE STE E, FONTANA, CA 92336-3329
(909) 356-4459
(909) 355-4261
Mailing address
1133 JUSTIN AVE APT 210, GLENDALE, CA 91201-1825
(513) 349-1791
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95013321
CA
Other
Enumeration date
11/21/2019
Last updated
08/02/2021
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