Provider Demographics
NPI:1508886250
Name:LATCH, DANIEL J (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:LATCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 VAN NESS AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5506
Mailing Address - Country:US
Mailing Address - Phone:415-775-4204
Mailing Address - Fax:415-775-5727
Practice Address - Street 1:1237 VAN NESS AVENUE,
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5506
Practice Address - Country:US
Practice Address - Phone:415-775-4204
Practice Address - Fax:415-775-5727
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25460111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ11493ZMedicare PIN
CAU83448Medicare UPIN