Provider Demographics
NPI:1346789815
Name:LATIOS, ARTURO (PTA)
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:
Last Name:LATIOS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8370 HERMOSA AVE APT B
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3701
Mailing Address - Country:US
Mailing Address - Phone:909-708-9989
Mailing Address - Fax:
Practice Address - Street 1:8370 HERMOSA AVE APT B
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3701
Practice Address - Country:US
Practice Address - Phone:909-708-9989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PTA48486172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker