Provider Demographics
NPI:1790841948
Name:FRANK TORTORICE MD. INC
Entity type:Organization
Organization Name:FRANK TORTORICE MD. INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JINPING
Authorized Official - Middle Name:
Authorized Official - Last Name:OU
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:650-692-7545
Mailing Address - Street 1:101 S SAN MATEO DR STE 303
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3844
Mailing Address - Country:US
Mailing Address - Phone:650-692-7545
Mailing Address - Fax:650-692-7609
Practice Address - Street 1:101 S SAN MATEO DR STE 303
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3844
Practice Address - Country:US
Practice Address - Phone:650-692-7545
Practice Address - Fax:650-692-7609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X
CA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ28679ZMedicare PIN