Provider Demographics
NPI:1932787538
Name:ROTTO, TORSTEN JACOB
Entity Type:Individual
Prefix:
First Name:TORSTEN
Middle Name:JACOB
Last Name:ROTTO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7829 SOMERSET CIR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2334
Mailing Address - Country:US
Mailing Address - Phone:651-472-2494
Mailing Address - Fax:
Practice Address - Street 1:455 O'CONNOR DRIVE INDIAN HEALTH CENTER - FMC
Practice Address - Street 2:#200
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128
Practice Address - Country:US
Practice Address - Phone:408-283-7676
Practice Address - Fax:408-283-7646
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program