Provider Demographics
NPI:1437881315
Name:TORRES, RENAN (PTA)
Entity Type:Individual
Prefix:
First Name:RENAN
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4668 HUNTINGTON DR S APT 123
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-1968
Mailing Address - Country:US
Mailing Address - Phone:323-903-1030
Mailing Address - Fax:
Practice Address - Street 1:802 BUENA VISTA ST
Practice Address - Street 2:
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-1702
Practice Address - Country:US
Practice Address - Phone:626-359-8141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant