Provider Demographics
NPI:1710187448
Name:ALAA M. LATIF, M.D., INC.
Entity Type:Organization
Organization Name:ALAA M. LATIF, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAA
Authorized Official - Middle Name:
Authorized Official - Last Name:LATIF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-857-1992
Mailing Address - Street 1:1900 ROYALTY DR STE 140
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3044
Mailing Address - Country:US
Mailing Address - Phone:909-620-0200
Mailing Address - Fax:909-620-0220
Practice Address - Street 1:1900 ROYALTY DR STE 140
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3044
Practice Address - Country:US
Practice Address - Phone:909-620-0200
Practice Address - Fax:909-620-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A519552Medicaid
CAF90570Medicare UPIN
CA00A519552Medicaid