Healthcare Provider Details

I. General information

NPI: 1447945647
Provider Name (Legal Business Name): TORRES PEDIATRICS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47647 CALEO BAY DR STE 230
LA QUINTA CA
92253-8859
US

IV. Provider business mailing address

47647 CALEO BAY DR STE 230
LA QUINTA CA
92253-8859
US

V. Phone/Fax

Practice location:
  • Phone: 760-474-8155
  • Fax: 442-372-7472
Mailing address:
  • Phone: 760-474-8155
  • Fax: 442-372-7472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EDGAR LIBARDO TORRES
Title or Position: CEO
Credential: MD
Phone: 617-610-3407