Provider Demographics
NPI:1639173610
Name:TORRES-QUINONES, MARTA I (MD)
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:I
Last Name:TORRES-QUINONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13112 EVENING CREEK DR S
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-4108
Mailing Address - Country:US
Mailing Address - Phone:858-668-3447
Mailing Address - Fax:516-512-5301
Practice Address - Street 1:13112 EVENING CREEK DR S
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128
Practice Address - Country:US
Practice Address - Phone:858-668-3447
Practice Address - Fax:516-512-5301
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96601207ZD0900X
PAMD418883207ZD0900X
CAA97194207ZD0900X
PR16374207ZD0900X
NY233640207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY57R611Medicare ID - Type Unspecified
PRI-27380Medicare UPIN
NYI27380Medicare UPIN
PR5-7971Medicare ID - Type Unspecified