Healthcare Provider Details

I. General information

NPI: 1831786003
Provider Name (Legal Business Name): VICTORIA N. FLORES, MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2020
Last Update Date: 12/22/2020
Certification Date: 12/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 NEVADA ST STE H
REDLANDS CA
92373-3139
US

IV. Provider business mailing address

570 NEVADA ST STE H
REDLANDS CA
92373-3139
US

V. Phone/Fax

Practice location:
  • Phone: 909-255-1507
  • Fax: 909-792-8378
Mailing address:
  • Phone: 909-255-1507
  • Fax: 909-792-8378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: DR. VICTORIA NICOLE FLORES
Title or Position: CEO
Credential: MD
Phone: 562-412-9144