Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 8878T | CA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 8878T | CA |
N | 152WP0200X | Pediatric Optomitrist | 8878T | CA |
NPI | 1346295474 |
---|---|
Provider Name | Anna M Torres |
First Address | Claremont, CA 91711-3528 |
Second Address | Claremont, CA 91711-3528 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 24/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
SD0088780 | (05) | CA |