Provider Demographics
NPI:1841847621
Name:DEL TORO, ANTHONY
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:DEL TORO
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 1:323 N TURNER AVE UNIT 1047
Mailing Address - Street 2:
Mailing Address - City:GUASTI
Mailing Address - State:CA
Mailing Address - Zip Code:91743-1605
Mailing Address - Country:US
Mailing Address - Phone:909-912-2861
Mailing Address - Fax:
Practice Address - Street 1:2852 E VIA TERRANO
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-6557
Practice Address - Country:US
Practice Address - Phone:909-912-2861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB7655227172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver