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General NPI Number Information
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NPI Number | 1548493570
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Entity Type | Individual
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Provider Name | DENISE RENEE TORBERT M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/25/2009
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | SANTA MARGARITA ROAD, BLDG H100 ATTENTION: CODE 094
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City | CAMP PENDLETON
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State | CA
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Zip | 92055-5191
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Country | US
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Telephone | 760-725-1394
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Fax |
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Provider Business Mailing Address
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Address Line | SANTA MARGARITA ROAD, BLDG H100 ATTENTION: CODE 094
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City | CAMP PENDLETON
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State | CA
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Zip | 92055-5191
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Country | US
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Telephone |
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | A114594
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License Number State | CA
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