Provider Demographics
NPI:1962233999
Name:LATAM MEDICAL NETWORK INC
Entity type:Organization
Organization Name:LATAM MEDICAL NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-988-6512
Mailing Address - Street 1:333 H ST STE 5000
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-5561
Mailing Address - Country:US
Mailing Address - Phone:619-988-6512
Mailing Address - Fax:
Practice Address - Street 1:AVE 3ERA Y CALLE CENTRAL
Practice Address - Street 2:
Practice Address - City:DAVID
Practice Address - State:CENTRAL
Practice Address - Zip Code:04010
Practice Address - Country:PA
Practice Address - Phone:507-774-0128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No291U00000XLaboratoriesClinical Medical Laboratory
No333600000XSuppliersPharmacy