NPIMap

Individual provider Active NPI

Barry Latner, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Concord, CA
National Provider Identifier
1275614562
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
G55864 Issued in CA
Practice address
2540 East St
Concord, CA 94520-1906
Phone
(925) 674-2506
Fax
(925) 674-2172
NPI assigned
Oct 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X G55864 CA Primary

Addresses

Primary practice location

2540 East St
Concord, CA 94520-1906

Mailing address

PO Box 1440
Suisun City, CA 94585-4440
Phone (510) 964-0458

Other identifiers 1

IdentifierTypeStateIssuer
00G558641OtherCAPPIN-MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051024001172 CA Part B Supplier - Clinic/Group Practice 6608893128 Receives reassigned benefits from 18 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Concord, CA; Daly City, CA; Pleasant Hill, CA; San Francisco, CA; Walnut Creek, CA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G55864CAMDAnatomic Pathology & Clinical Pathology Physician

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275614562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1440",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945854440",
            "telephone_number": "510-964-0458",
            "fax_number": "510-964-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 EAST ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945201906",
            "telephone_number": "925-674-2506",
            "fax_number": "925-674-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATNER",
        "first_name": "BARRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G55864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPIN-MEDICARE",
            "identifier": "00G558641",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.