Healthcare Provider Details

I. General information

NPI: 1922031814
Provider Name (Legal Business Name): JOSEPH TORRES O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 EMBARCADERO CTR LBBY LEVEL
SAN FRANCISCO CA
94111-5900
US

IV. Provider business mailing address

676 TERESITA BLVD
SAN FRANCISCO CA
94127-2320
US

V. Phone/Fax

Practice location:
  • Phone: 415-772-8282
  • Fax: 415-772-8222
Mailing address:
  • Phone: 415-586-9940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number8879 TPA
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: