1528126042 NPI number — JOSEPH TORRES, O.D., A PROFESSIONAL OPTOMETRIC CORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528126042 NPI number — JOSEPH TORRES, O.D., A PROFESSIONAL OPTOMETRIC CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOSEPH TORRES, O.D., A PROFESSIONAL OPTOMETRIC CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528126042
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 EMBARCADERO CTR
Provider Second Line Business Mailing Address:
LOBBY LEVEL
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94111-5900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-772-8282
Provider Business Mailing Address Fax Number:
415-772-8222

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 EMBARCADERO CTR
Provider Second Line Business Practice Location Address:
LOBBY LEVEL
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94111-5900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-772-8282
Provider Business Practice Location Address Fax Number:
415-772-8222
Provider Enumeration Date:
12/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
IRVING
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
Authorized Official Title or Position:
V.P. AND SECRETARY
Authorized Official Telephone Number:
415-772-8282

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  CA OPT 8879 TPA , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0088790 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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