Healthcare Provider Details

I. General information

NPI: 1295407450
Provider Name (Legal Business Name): BEATRIZ TORRES ESPINOZA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2021
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLVD LAS AMERICAS PASEO DE LOS HEROES, VEINTE DE NOVIEMBRE
TIJUANA BAJA CALIFORNIA
22100
MX

IV. Provider business mailing address

4688 F ST
SAN DIEGO CA
92102-3666
US

V. Phone/Fax

Practice location:
  • Phone: 619-272-9021
  • Fax: 619-329-9663
Mailing address:
  • Phone: 619-272-9021
  • Fax: 619-339-9663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. BEATRIZ TORRES ESPINOZA
Title or Position: DENTIST
Credential: DDS
Phone: 619-272-9021