Provider Demographics
NPI:1013017961
Name:TORRES, CATHERINE DIANE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:DIANE
Last Name: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:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAELS
Mailing Address - State:AZ
Mailing Address - Zip Code:86511-0370
Mailing Address - Country:US
Mailing Address - Phone:505-556-8200
Mailing Address - Fax:505-556-8159
Practice Address - Street 1:359A WEST HIGHWAY 264
Practice Address - Street 2:
Practice Address - City:SAINT MICHAELS
Practice Address - State:AZ
Practice Address - Zip Code:86511
Practice Address - Country:US
Practice Address - Phone:928-810-3800
Practice Address - Fax:928-810-3811
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM95360208000000X
OK17696208D00000X
AZ55164208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMH4195Medicaid