Provider Demographics
NPI:1700571304
Name:PINA-TORRES, MISAEL
Entity type:Individual
Prefix:MR
First Name:MISAEL
Middle Name:
Last Name:PINA-TORRES
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 1:12201 GARVEY AVE TRLR 11
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-3154
Mailing Address - Country:US
Mailing Address - Phone:626-586-4479
Mailing Address - Fax:
Practice Address - Street 1:12201 GARVEY AVE TRLR 11
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-3154
Practice Address - Country:US
Practice Address - Phone:626-586-4479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program