Provider Demographics
NPI:1679792287
Name:TORREY, MELISSA L (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:L
Last Name:TORREY
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 1:245 TERRACINA BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4867
Mailing Address - Country:US
Mailing Address - Phone:909-793-4336
Mailing Address - Fax:909-793-3325
Practice Address - Street 1:245 TERRACINA BLVD STE 206
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4867
Practice Address - Country:US
Practice Address - Phone:909-793-4336
Practice Address - Fax:909-793-3325
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88472207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A884720Medicaid
CA00A884720Medicaid