Provider Demographics
NPI:1699282517
Name:TORCHIA, CRAIG ALAN
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:ALAN
Last Name:TORCHIA
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 1:12-158 KIPUKA ST
Mailing Address - Street 2:
Mailing Address - City:PAHOA
Mailing Address - State:HI
Mailing Address - Zip Code:96778-8029
Mailing Address - Country:US
Mailing Address - Phone:949-235-9997
Mailing Address - Fax:
Practice Address - Street 1:12-158 KIPUKA ST
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-8029
Practice Address - Country:US
Practice Address - Phone:949-235-9997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-30
Last Update Date:2017-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI15115225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist