Healthcare Provider Details

I. General information

NPI: 1316868912
Provider Name (Legal Business Name): BALDEMAR TORRES OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4306 BIXBY WAY
MERCED CA
95348-9652
US

IV. Provider business mailing address

4306 BIXBY WAY
MERCED CA
95348-9652
US

V. Phone/Fax

Practice location:
  • Phone: 209-201-6986
  • Fax:
Mailing address:
  • Phone: 209-201-6986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36359
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: