Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 95360 | NM |
N | 208D00000X | General Practice Physician | 17696 | OK |
Y | 208D00000X | General Practice Physician | 55164 | AZ |
NPI | 1013017961 |
---|---|
Provider Name | Dr. Catherine Diane Torres |
First Address | Saint Michaels, AZ 86511-0370 |
Second Address | Saint Michaels, AZ 86511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 27/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H4195 | (05) | NM |