Healthcare Provider Details

I. General information

NPI: 1417680521
Provider Name (Legal Business Name): DAISY Z TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2022
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32121 CAMINO CAPISTRANO
SAN JUAN CAPISTRANO CA
92675-3716
US

IV. Provider business mailing address

32802 VALLE RD SPC 39
SAN JUAN CAPISTRANO CA
92675-4523
US

V. Phone/Fax

Practice location:
  • Phone: 949-493-2178
  • Fax: 949-493-9679
Mailing address:
  • Phone: 949-289-3433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberTCH173037
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: