Healthcare Provider Details
I. General information
NPI: 1114147592
Provider Name (Legal Business Name): FRANKLIN KIEU TORRES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/26/2007
Last Update Date: 10/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3660 PARK SIERRA DR STE 105
RIVERSIDE CA
92505-3071
US
IV. Provider business mailing address
PO BOX 2828
CORONA CA
92878-2828
US
V. Phone/Fax
- Phone: 951-278-8870
- Fax: 951-278-8913
- Phone: 951-278-8870
- Fax: 951-278-8913
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | 94-06585 |
| License Number State | KS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: