Healthcare Provider Details

I. General information

NPI: 1790841948
Provider Name (Legal Business Name): FRANK TORTORICE MD. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 04/26/2024
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S SAN MATEO DR STE 303
SAN MATEO CA
94401-3844
US

IV. Provider business mailing address

101 S SAN MATEO DR STE 303
SAN MATEO CA
94401-3844
US

V. Phone/Fax

Practice location:
  • Phone: 650-692-7545
  • Fax: 650-692-7609
Mailing address:
  • Phone: 650-692-7545
  • Fax: 650-692-7609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JINPING OU
Title or Position: MANAGER
Credential: MS
Phone: 650-692-7545