Healthcare Provider Details

I. General information

NPI: 1740230796
Provider Name (Legal Business Name): JANET HOYT FLYNN CNS, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W 3RD ST
AZUSA CA
91702-3328
US

IV. Provider business mailing address

117 W SIERRA MADRE AVE
GLENDORA CA
91741-2020
US

V. Phone/Fax

Practice location:
  • Phone: 626-812-2282
  • Fax: 626-812-8181
Mailing address:
  • Phone: 626-963-1107
  • Fax: 626-812-8181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number173589
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: