Provider Demographics
NPI:1912061052
Name:ALVARO TORRES CACERES MD INC
Entity Type:Organization
Organization Name:ALVARO TORRES CACERES MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:T
Authorized Official - Last Name:CACERES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-725-6461
Mailing Address - Street 1:1205 GARCES HWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-3639
Mailing Address - Country:US
Mailing Address - Phone:661-725-6461
Mailing Address - Fax:661-725-9271
Practice Address - Street 1:1205 GARCES HWY STE 201
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-3657
Practice Address - Country:US
Practice Address - Phone:661-725-6461
Practice Address - Fax:661-725-9271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG377331207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G377331Medicaid
CA00G377331Medicare ID - Type UnspecifiedPROVIDER NUMBER
CAA47209Medicare UPIN