Provider Demographics
NPI:1730121815
Name:TORRIJOS, EMMA B (MD)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:B
Last Name:TORRIJOS
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:PO BOX 769609
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-8224
Mailing Address - Country:US
Mailing Address - Phone:770-903-0130
Mailing Address - Fax:770-903-0131
Practice Address - Street 1:6330 PRIMROSE HILL CT
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-4544
Practice Address - Country:US
Practice Address - Phone:770-903-0130
Practice Address - Fax:770-903-0131
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA65620208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003109375AMedicaid
GA1609816123OtherGEORGIA CLINIC PC GROUP NPI #