Healthcare Provider Details

I. General information

NPI: 1508471731
Provider Name (Legal Business Name): STEPHEN J. TORRES, M.D., A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2020
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11710 WILSHIRE BLVD
LOS ANGELES CA
90025-1503
US

IV. Provider business mailing address

11710 WILSHIRE BLVD
LOS ANGELES CA
90025-1503
US

V. Phone/Fax

Practice location:
  • Phone: 310-828-5441
  • Fax:
Mailing address:
  • Phone: 646-571-8688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN JAMES TORRES
Title or Position: PRESIDENT
Credential: MD
Phone: 646-571-8688