Provider Demographics
NPI:1285712836
Name:TORRES, MICHELLE (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 FRANKLIN PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-1922
Mailing Address - Country:US
Mailing Address - Phone:650-358-7000
Mailing Address - Fax:
Practice Address - Street 1:1000 FRANKLIN PKWY
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1922
Practice Address - Country:US
Practice Address - Phone:650-358-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01073234A207R00000X
CAA71967207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A719670Medicaid
IN201279680Medicaid
INP01512449OtherRR MEDICARE
INP01512449OtherRR MEDICARE
IN266180518Medicare PIN