Provider Demographics
NPI:1962438192
Name:TORO, CLARA M (MD)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:M
Last Name:TORO
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:PO BOX 5554
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91912-5554
Mailing Address - Country:US
Mailing Address - Phone:619-291-9285
Mailing Address - Fax:
Practice Address - Street 1:340 4TH AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-3813
Practice Address - Country:US
Practice Address - Phone:619-291-9285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG59827207K00000X, 207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Not Answered207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G598271Medicaid
CAG59827Medicare ID - Type Unspecified
CA00G598271Medicaid