Healthcare Provider Details

I. General information

NPI: 1083199194
Provider Name (Legal Business Name): FEDERICO AUGUSTO TORRES NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 05/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 W CENTRAL AVE APT 37
SANTA ANA CA
92704-5774
US

IV. Provider business mailing address

808 W 58TH ST
LOS ANGELES CA
90037-3632
US

V. Phone/Fax

Practice location:
  • Phone: 714-914-5982
  • Fax:
Mailing address:
  • Phone: 323-541-1411
  • Fax: 877-720-7181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPF95010056
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: