Healthcare Provider Details

I. General information

NPI: 1306985742
Provider Name (Legal Business Name): VICTOR ROBERTO TORRES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 MAIN ST SUITE 203
BRAWLEY CA
92227-2392
US

IV. Provider business mailing address

815 ENCANTO TER
CALEXICO CA
92231-2521
US

V. Phone/Fax

Practice location:
  • Phone: 760-351-2800
  • Fax: 760-351-7701
Mailing address:
  • Phone: 760-693-9584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: