Healthcare Provider Details

I. General information

NPI: 1386610665
Provider Name (Legal Business Name): RONALD R FLORES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 CREEKSIDE DR SUITE 1400
FOLSOM CA
95630-3444
US

IV. Provider business mailing address

2162 OUTRIGGER DR
EL DORADO HILLS CA
95762-3735
US

V. Phone/Fax

Practice location:
  • Phone: 916-984-8244
  • Fax: 916-984-8388
Mailing address:
  • Phone: 916-933-5372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG067630
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: