Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 31282 | AZ |
NPI | 1114974524 |
---|---|
Provider Name | Dr. Steven Torres |
First Address | Mesa, AZ 85215-0809 |
Second Address | Chandler, AZ 85224-5605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 05/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AZ0736120 | BC/BS (01) | AZ |
G93634 | (02) | AZ |