Provider Demographics
NPI:1144292251
Name:LATIF, SHEIKH ALTAF (DO)
Entity type:Individual
Prefix:
First Name:SHEIKH
Middle Name:ALTAF
Last Name:LATIF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 W. LACEY BLVD.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230
Mailing Address - Country:US
Mailing Address - Phone:877-360-8346
Mailing Address - Fax:877-360-8346
Practice Address - Street 1:4351 E LOHMAN AVE STE 202
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8260
Practice Address - Country:US
Practice Address - Phone:575-522-5955
Practice Address - Fax:575-522-6228
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9229208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
I44734Medicare UPIN
CAI44734Medicare UPIN
OOAX92291Medicare PIN