Healthcare Provider Details

I. General information

NPI: 1457540551
Provider Name (Legal Business Name): FRANK TORTORICE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
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 TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA54494
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA54494
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: