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NPI Code Detail

MEDICARE: DANIEL MADERO FLORES SUDCC

MEDICARE: DANIEL MADERO FLORES SUDCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor6896CA

General Provider Information

NPI Number : 1962705186
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL MADERO FLORES SUDCC
Provider Business Mailing Address
First Line : 4441 E CESAR CHAVEZ BLVD
Second Line :
City : FRESNO
State : CA
Zip : 93702-3604
Country : US
Telephone Number : 559-600-4099
Fax Number : 559-498-7111
Provider Business Practice Location Address
First Line : 1925 E DAKOTA AVE
Second Line :
City : FRESNO
State : CA
Zip : 93726-4821
Country : US
Telephone Number : 559-600-4600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2010
Last Update Date : 03/09/2026

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