Provider Demographics
NPI:1932754637
Name:TORRES, ALVARO FABRICIO (OD)
Entity Type:Individual
Prefix:DR
First Name:ALVARO
Middle Name:FABRICIO
Last Name:TORRES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 E PALM CANYON DR APT 113
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-4882
Mailing Address - Country:US
Mailing Address - Phone:661-974-1821
Mailing Address - Fax:
Practice Address - Street 1:47474 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-8846
Practice Address - Country:US
Practice Address - Phone:760-564-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34322TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist