Latitude 19 Medical Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

DOS-685 Issued in HI

Legal business name

LATITUDE 19 MEDICAL INC.

Practice address

75-5591 Palani Rd
Kailua Kona, HI 96740-3631

Phone

(808) 640-3460

NPI assigned

Sep 22, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Russell Alan Parker, D.O.

Title

President

Phone

(719) 237-0590

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442880000000",
    "number": "1669841458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5737 KUAKINI HWY STE 202",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401725",
            "telephone_number": "808-640-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5591 PALANI RD",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403631",
            "telephone_number": "808-640-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LATITUDE 19 MEDICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-22",
        "last_updated": "2015-09-22",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-237-0590",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "HI",
            "license": "DOS-685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chandroutie Pam Lange, LAC
• Bianka L Lankford Leborio, APRN
• Justin Larkin, MA
• Anna Larson-Dola, PA-C
• Adam Jerome Larson
• Marcy H. Latteman
• Corinne O Laurance, M.D.
• Nyle Hiroshi Le
• Kaikala Lealao
• Lucinda Gifford Learned, LMT

• Clinic/Center in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.