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General NPI Number Information
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NPI Number | 1043538150
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Entity Type | Individual
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Provider Name | EDGAR LIBARDO TORRES M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/13/2010
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 47647 CALEO BAY DR STE 230
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City | LA QUINTA
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State | CA
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Zip | 92253-8859
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Country | US
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Telephone | 760-474-8155
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Fax | 442-372-7472
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Provider Business Mailing Address
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Address Line | 47647 CALEO BAY DR STE 230
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City | LA QUINTA
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State | CA
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Zip | 92253-8859
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Country | US
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Telephone | 760-474-8155
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Fax | 442-372-7472
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 244039
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036-133245
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | C173179
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | C173179
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License Number State | CA
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