Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 94-06585 | KS |
NPI | 1114147592 |
---|---|
Provider Name | Dr. Franklin Kieu Torres |
First Address | Corona, CA 92878-2828 |
Second Address | Riverside, CA 92505-3071 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 06/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A102885 | CALIFORNIA MEDICAL LICENSE (01) | CA |