Healthcare Provider Details

I. General information

NPI: 1750305868
Provider Name (Legal Business Name): CHRISTINA FLORES D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3102 STORY RD
SAN JOSE CA
95127-3815
US

IV. Provider business mailing address

PO BOX 56183
SAN JOSE CA
95156-6183
US

V. Phone/Fax

Practice location:
  • Phone: 408-258-8919
  • Fax: 408-258-5858
Mailing address:
  • Phone: 408-258-8919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE3939
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: