Healthcare Provider Details

I. General information

NPI: 1730582248
Provider Name (Legal Business Name): MONICA FLORES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2014
Last Update Date: 10/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SOUTH COMMONWEALTH AVENUE
LOS ANGELES CA
90006
US

IV. Provider business mailing address

600 S COMMONWEALTH AVE
LOS ANGELES CA
90005-4001
US

V. Phone/Fax

Practice location:
  • Phone: 213-639-6434
  • Fax: 213-639-1035
Mailing address:
  • Phone: 213-639-6434
  • Fax: 213-639-1035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number462937
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: