Provider Demographics
NPI:1942215686
Name:LATIF, SEEMA (MD)
Entity Type:Individual
Prefix:DR
First Name:SEEMA
Middle Name:
Last Name:LATIF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 REMITTANCE DR DEPT 6008
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60675-6008
Mailing Address - Country:US
Mailing Address - Phone:562-282-1419
Mailing Address - Fax:562-920-4642
Practice Address - Street 1:11480 BROOKSHIRE
Practice Address - Street 2:SUITE #204
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5026
Practice Address - Country:US
Practice Address - Phone:562-862-2775
Practice Address - Fax:562-904-8095
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52771208000000X
CA52771208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A527710Medicaid
CA00A527710OtherBLUE SHIELD
CA370020278OtherMEDICARE RAILROAD
CA370020278OtherRAILROAD MEDICARE
CA00A527710OtherBLUE SHIELD
CAWA52771CMedicare PIN