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General NPI Number Information
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NPI Number | 1114125887
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Entity Type | Individual
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Provider Name | JOSE LUIS FLORES D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/04/2007
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Last Update Date | 05/03/2016
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Provider Practice Location Address
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Address Line | 8617 CALIFORNIA AVE
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City | SOUTH GATE
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State | CA
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Zip | 90280-3003
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Country | US
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Telephone | 323-564-5858
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Fax | 323-564-7212
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Provider Business Mailing Address
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Address Line | 11510 DOWNEY AVE
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City | DOWNEY
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State | CA
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Zip | 90241-4937
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Country | US
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Telephone | 562-862-2600
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Fax | 562-862-5676
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 33577
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License Number State | CA
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