Provider Demographics
NPI:1578999124
Name:TORRES, ALEJANDRO (PA)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:150 TEJAS PL
Mailing Address - Street 2:
Mailing Address - City:NIPOMO
Mailing Address - State:CA
Mailing Address - Zip Code:93444-9123
Mailing Address - Country:US
Mailing Address - Phone:805-929-3211
Mailing Address - Fax:805-929-6359
Practice Address - Street 1:425 W CENTRAL AVE
Practice Address - Street 2:201
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-2805
Practice Address - Country:US
Practice Address - Phone:805-737-1169
Practice Address - Fax:805-737-1772
Is Sole Proprietor?:No
Enumeration Date:2013-09-15
Last Update Date:2013-10-18
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA151013Medicare Oscar/Certification