Healthcare Provider Details

I. General information

NPI: 1366420317
Provider Name (Legal Business Name): CALVIN FLOWERS, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 07/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 E FOOTHILL BLVD
RIALTO CA
92376-5230
US

IV. Provider business mailing address

79405 HIGHWAY 111 # 9458
LA QUINTA CA
92253-8300
US

V. Phone/Fax

Practice location:
  • Phone: 909-421-9301
  • Fax:
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: DR. CALVIN FLOWERS
Title or Position: OWNER
Credential: MD
Phone: 760-799-8931