Healthcare Provider Details

I. General information

NPI: 1225948367
Provider Name (Legal Business Name): FLOURISH MEDICAL CA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 S SPRING ST UNIT 13308
LOS ANGELES CA
90013-3215
US

IV. Provider business mailing address

2751 SCENIC DR
ALAMOGORDO NM
88310-8730
US

V. Phone/Fax

Practice location:
  • Phone: 575-495-1244
  • Fax:
Mailing address:
  • Phone: 575-495-1244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: SASWATHA ANIREDDY
Title or Position: OWNER
Credential:
Phone: 575-495-1244