Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | A51871 | CA |
NPI | 1013091461 |
---|---|
Provider Name | Dr. Javier Torres |
First Address | Culver City, CA 90232-2415 |
Second Address | Beverly Hills, CA 90211-2227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A51871 | MEDICAL LICENS (01) | CA |