Healthcare Provider Details

I. General information

NPI: 1700945136
Provider Name (Legal Business Name): JOSE LUIS FLORES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 O ST STE 202
FRESNO CA
93721-1828
US

IV. Provider business mailing address

63 ROSEWOOD CIR
MADERA CA
93637-2673
US

V. Phone/Fax

Practice location:
  • Phone: 559-369-4625
  • Fax:
Mailing address:
  • Phone: 559-674-8657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA69861
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: