Provider Demographics
NPI:1821163460
Name:TORRES MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:TORRES MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-983-8810
Mailing Address - Street 1:1300 N VENTURA RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-3836
Mailing Address - Country:US
Mailing Address - Phone:805-983-8810
Mailing Address - Fax:805-983-8821
Practice Address - Street 1:1300 N VENTURA RD
Practice Address - Street 2:SUITE 6
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-3836
Practice Address - Country:US
Practice Address - Phone:805-983-8810
Practice Address - Fax:805-983-8821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50648261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A506480Medicaid
CAF44300Medicare UPIN
CA00A506480Medicaid