Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | A25606 | CA |
NPI | 1386744357 |
---|---|
Provider Name | Mr. Jesus Anibal Torpoco |
First Address | Reseda, CA 91335-6308 |
Second Address | Reseda, CA 91335-6308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 09/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A256060 | (05) | CA |
C03850 | (02) | CA |