Provider Demographics
NPI:1215418637
Name:TORRES, NEAL ESTOPAR
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:ESTOPAR
Last Name:TORRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 LA HONDA WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-2624
Mailing Address - Country:US
Mailing Address - Phone:916-300-4533
Mailing Address - Fax:916-944-8909
Practice Address - Street 1:3940 LA HONDA WAY
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-2624
Practice Address - Country:US
Practice Address - Phone:916-300-4533
Practice Address - Fax:916-944-8909
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347001696310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility