Healthcare Provider Details

I. General information

NPI: 1699353011
Provider Name (Legal Business Name): WILLIAM ALLEN LATSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 E HERNDON AVE STE 850
FRESNO CA
93720-3309
US

IV. Provider business mailing address

1303 E HERNDON AVE STE 850
FRESNO CA
93720-3309
US

V. Phone/Fax

Practice location:
  • Phone: 559-450-5672
  • Fax:
Mailing address:
  • Phone: 559-450-5672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA189163
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA189163
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA189163
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME175625
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: