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General NPI Number Information
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NPI Number | 1003699489
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Entity Type | Individual
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Provider Name | ISABEL DE LA TORRE
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Gender | Female
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Dates
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Enumeration Date | 08/17/2023
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 1950 THIRD STREET
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City | LA VERNE
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State | CA
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Zip | 91750
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Country | US
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Telephone | 626-478-5732
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Fax |
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Provider Business Mailing Address
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Address Line | 4255 FILHURST AVE
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City | BALDWIN PARK
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State | CA
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Zip | 91706-2851
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Country | US
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Telephone | 626-478-5732
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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