Provider Demographics
NPI:1578651584
Name:TORRES, RODRIGO J (MD)
Entity Type:Individual
Prefix:
First Name:RODRIGO
Middle Name:J
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:2650 ELM AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1651
Mailing Address - Country:US
Mailing Address - Phone:562-427-5409
Mailing Address - Fax:562-426-6321
Practice Address - Street 1:2650 ELM AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1651
Practice Address - Country:US
Practice Address - Phone:562-427-5409
Practice Address - Fax:562-426-6321
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2009-03-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA83341207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
BC911ZMedicare PIN
I37012Medicare UPIN