Healthcare Provider Details

I. General information

NPI: 1720810005
Provider Name (Legal Business Name): FRANCISCO TORRES JR. PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2024
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 E BETTERAVIA RD STE 201
SANTA MARIA CA
93454-7023
US

IV. Provider business mailing address

966 FIGUEROA DR
SAN LEANDRO CA
94578-4037
US

V. Phone/Fax

Practice location:
  • Phone: 805-621-7714
  • Fax:
Mailing address:
  • Phone: 510-368-4452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1720810005
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: