Provider Demographics
NPI:1861467292
Name:ISIDORO-TORRES, MARINOR CUETO (MD)
Entity Type:Individual
Prefix:
First Name:MARINOR
Middle Name:CUETO
Last Name:ISIDORO-TORRES
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 1:1300 N VENTURA RD
Mailing Address - Street 2:SUITE 8
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 8
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
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63740207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G637400Medicaid
CA00G637400Medicaid
CAW18259Medicare ID - Type Unspecified