MEDICARE: MR. ALEXANDER THOMAS LATTERI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	C38154	CA

General Provider Information

NPI Number	:	1427086321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALEXANDER THOMAS LATTERI MD

Provider Business Mailing Address
First Line	:	3939 ATLANTIC AVENUE
Second Line	:	SUITE #204
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3535
Country	:	US
Telephone Number	:	562-424-0423
Fax Number	:	562-424-6719

Provider Business Practice Location Address
First Line	:	3939 ATLANTIC AVENUE
Second Line	:	SUITE #204
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3535
Country	:	US
Telephone Number	:	562-424-0423
Fax Number	:	562-424-6719

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	07/08/2007

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