Provider Demographics
NPI:1740305358
Name:TORREY, DONALD VICTOR (RPT)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:VICTOR
Last Name:TORREY
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11251 COLOMA RD
Mailing Address - Street 2:STE J
Mailing Address - City:GOLD RIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95670-4431
Mailing Address - Country:US
Mailing Address - Phone:916-353-2270
Mailing Address - Fax:916-353-2279
Practice Address - Street 1:2801 K ST
Practice Address - Street 2:STE 310
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5120
Practice Address - Country:US
Practice Address - Phone:916-454-6677
Practice Address - Fax:916-353-2279
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT9080174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PT90481OtherBLUE SHIELD
CAPT9080OtherBLUE CROSS
CA00PT90482Medicare UPIN
CAPT9080OtherBLUE CROSS
CAP00296136Medicare ID - Type UnspecifiedMEDICARE RAILROAD