Healthcare Provider Details

I. General information

NPI: 1669492948
Provider Name (Legal Business Name): CALVIN J FLOWERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 09/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47040 WASHINGTON ST STE 3202
LA QUINTA CA
92253-2628
US

IV. Provider business mailing address

47040 WASHINGTON ST STE 3202
LA QUINTA CA
92253-2628
US

V. Phone/Fax

Practice location:
  • Phone: 760-799-8931
  • Fax: 800-886-6465
Mailing address:
  • Phone: 760-799-8931
  • Fax: 800-886-6465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG77508
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberG77508
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: