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General NPI Number Information
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NPI Number | 1619965506
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Entity Type | Individual
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Provider Name | ALAA LATIF MD
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Gender | Male
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 1910 ROYALTY DRIVE
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City | POMONA
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State | CA
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Zip | 91767-5176
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Country | US
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Telephone | 909-630-7290
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Fax | 909-630-7299
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Provider Business Mailing Address
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Address Line | 1900 ROYALTY DR STE 140
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City | POMONA
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State | CA
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Zip | 91767-3044
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Country | US
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Telephone | 909-620-0200
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Fax | 909-620-0220
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A51955
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License Number State | CA
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