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Individual

MINERVA C TORRES-MALLANTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5250 CLAREMONT AVE STE 212, STOCKTON, CA 95207-5700
(209) 644-7000
Mailing address
4732 EDGEBROOK AVE, STOCKTON, CA 95206-6221
(209) 406-9800

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
582432009
PASSPORT
CA
01
A1387891
DRIVER LICENSE
CA
Enumeration date
07/09/2018
Last updated
07/09/2018
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