Healthcare Provider Details

I. General information

NPI: 1992389811
Provider Name (Legal Business Name): ARTURO TORRES RDA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 05/06/2021
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2604 S VERMONT AVE STE F
LOS ANGELES CA
90007-2298
US

IV. Provider business mailing address

266 THORNE ST APT C
LOS ANGELES CA
90042-5601
US

V. Phone/Fax

Practice location:
  • Phone: 310-820-9933
  • Fax:
Mailing address:
  • Phone: 323-359-7428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License NumberRDA87714
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: