Healthcare Provider Details

I. General information

NPI: 1215131008
Provider Name (Legal Business Name): VICTOR JAIME TORRES N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 08/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8727 VAN NUYS BLVD # 101102
PANORAMA CITY CA
91402
US

IV. Provider business mailing address

810 W NAOMI AVE UNIT 1
ARCADIA CA
91007-7520
US

V. Phone/Fax

Practice location:
  • Phone: 818-899-5555
  • Fax: 818-899-5969
Mailing address:
  • Phone: 626-446-3076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number16528
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: