| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MERCEDES TORRES | 1700474269 | 2021-01-09 |
| Entity Type | Individual |
| Provider Name | Mercedes Torres |
| Practice Office Address | 3620 W HAMMER LN STOCKTON, CA US |
| Practice Office Telephone | 8665234268 |
| Mailing Address | PO BOX 399318 SAN FRANCISCO, CA 941399318 US |
| Business Telephone | 8665234268 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 1804 Saint Lakes Way | Stockton, CA 952064672 | 2092980011 |
| Code | License No | State |
|---|---|---|
| 106S00000X PRIMARY |