Healthcare Provider Details

I. General information

NPI: 1144828211
Provider Name (Legal Business Name): DIEGO XAVIER TORRES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4610 X ST
SACRAMENTO CA
95817-2200
US

IV. Provider business mailing address

4610 X ST
SACRAMENTO CA
95817-2200
US

V. Phone/Fax

Practice location:
  • Phone: 916-816-1834
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberG189611
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: