Healthcare Provider Details

I. General information

NPI: 1871523670
Provider Name (Legal Business Name): SANDRA TORRES MD, MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 S WHITE RD SUITE 200
SAN JOSE CA
95148-2076
US

IV. Provider business mailing address

2690 S WHITE RD SUITE 200
SAN JOSE CA
95148-2076
US

V. Phone/Fax

Practice location:
  • Phone: 408-223-8080
  • Fax: 408-223-8088
Mailing address:
  • Phone: 408-223-8080
  • Fax: 408-223-8088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberA73641
License Number StateCA

VIII. Authorized Official

Name: DR. SANDRA TORRES
Title or Position: PRESIDENT
Credential: MD
Phone: 408-223-8080