Provider Demographics
NPI:1629847223
Name:TORRES, DIEGO JOSE (CO)
Entity type:Individual
Prefix:MR
First Name:DIEGO
Middle Name:JOSE
Last Name:TORRES
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-2404
Mailing Address - Country:US
Mailing Address - Phone:760-457-7172
Mailing Address - Fax:
Practice Address - Street 1:126 N 5TH ST
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-2404
Practice Address - Country:US
Practice Address - Phone:760-457-7172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician