Active NPI
Gary Latonio, CDM MANAGER
- Dietary Manager
- Panorama City, CA
National Provider Identifier
1023781390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dietary Manager
- License
- 170408
- Practice address
- 14363 Lorne St
Panorama City, CA 91402-5207 - Phone
- (818) 268-8748
- NPI assigned
- Jul 31, 2021
- Last updated
- Jul 31, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dietary Manager | 132700000X | 170408 | CA | Primary |
Addresses
Primary practice location
14363 Lorne St
Panorama City, CA 91402-5207
Mailing address
14363 Lorne St
Panorama City, CA 91402
Phone (818) 268-8745
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 170408 | CA | MD | Dietary Manager |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627689600000",
"number": "1023781390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14363 LORNE ST",
"city": "PANORAMA CITY",
"state": "CA",
"postal_code": "91402",
"telephone_number": "818-268-8745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14363 LORNE ST",
"city": "PANORAMA CITY",
"state": "CA",
"postal_code": "914025207",
"telephone_number": "818-268-8748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATONIO",
"first_name": "GARY",
"credential": "CDM MANAGER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-31",
"last_updated": "2021-07-31",
"certification_date": "2021-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "132700000X",
"taxonomy_group": "",
"desc": "Dietary Manager",
"state": "CA",
"license": "170408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Panorama City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.