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General NPI Number Information
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NPI Number | 1225081821
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Entity Type | Organization
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Legal Business Name | WEST ALLIS PRIMARY CARE PHYSICIANS, S.C.
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2424 S 90TH ST #302
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City | WEST ALLIS
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State | WI
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Zip | 53227-2455
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Country | US
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Telephone | 414-328-8747
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Fax | 414-328-8676
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Provider Business Mailing Address
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Address Line | 2424 S 90TH ST #302
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City | WEST ALLIS
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State | WI
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Zip | 53227-2455
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Country | US
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Telephone | 414-328-8747
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Fax | 414-328-8676
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. SANDRA C. TORRES
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Credential | M.D.
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Telephone | 414-328-8781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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