Healthcare Provider Details

I. General information

NPI: 1023827789
Provider Name (Legal Business Name): PAOLA L TORRES-CRUZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 ZONAL AVE
LOS ANGELES CA
90033-1026
US

IV. Provider business mailing address

121 W MADISON AVE
MONTEBELLO CA
90640-4430
US

V. Phone/Fax

Practice location:
  • Phone: 323-409-3000
  • Fax:
Mailing address:
  • Phone: 818-568-2689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number95222320
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: