Healthcare Provider Details

I. General information

NPI: 1275274144
Provider Name (Legal Business Name): ALEJANDRO SOLIS TORRES FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALEX SOLIS TORRES FNP

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 04/06/2022
Certification Date: 04/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 N TRAVERSE AVE
CLOVIS CA
93619-8044
US

IV. Provider business mailing address

1323 N TRAVERSE AVE
CLOVIS CA
93619-8044
US

V. Phone/Fax

Practice location:
  • Phone: 559-265-2902
  • Fax:
Mailing address:
  • Phone: 559-265-2902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95020208
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: