Healthcare Provider Details

I. General information

NPI: 1033026737
Provider Name (Legal Business Name): ALEJANDRO JOSUE FLORES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4618 FOUNTAIN AVE
LOS ANGELES CA
90029-1830
US

IV. Provider business mailing address

9016 UNION ST
PICO RIVERA CA
90660-2049
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-3814
  • Fax:
Mailing address:
  • Phone: 346-500-4039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: