Healthcare Provider Details

I. General information

NPI: 1992260053
Provider Name (Legal Business Name): HERMIL CLAIRE MACALUA TORREDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2019
Last Update Date: 08/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 CALIFORNIA ST STE 570
SAN FRANCISCO CA
94109-4591
US

IV. Provider business mailing address

37591 BREAKERS RD
NEWARK CA
94560-3477
US

V. Phone/Fax

Practice location:
  • Phone: 415-673-9199
  • Fax:
Mailing address:
  • Phone: 407-927-3474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95009077
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: