Provider Demographics
NPI:1093083313
Name:TORRANCE CLINICAL RESEARCH INSTITUTE INC.
Entity Type:Organization
Organization Name:TORRANCE CLINICAL RESEARCH INSTITUTE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAIKHEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-373-8120
Mailing Address - Street 1:25043 NARBONNE AVE
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-2101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25043 NARBONNE AVE
Practice Address - Street 2:
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-2101
Practice Address - Country:US
Practice Address - Phone:310-373-8120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
A49056OtherSTATE LICENSE
BR2684341OtherDEA
A49056OtherSTATE LICENSE