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General NPI Number Information
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NPI Number | 1902119449
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Entity Type | Organization
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Legal Business Name | ROBERT O. FLORES, M.D. INC.
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 11273 LAUREL CANYON BLVD SUITE 1
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City | SAN FERNANDO
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State | CA
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Zip | 91340-4300
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Country | US
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Telephone | 818-365-3978
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Fax |
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Provider Business Mailing Address
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Address Line | 11273 LAUREL CANYON BLVD SUITE 1
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City | SAN FERNANDO
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State | CA
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Zip | 91340-4300
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Country | US
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Telephone | 818-365-3978
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ROBERT FLORES
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Credential | M.D.
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Telephone | 818-365-3978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | G40429
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License Number State | CA
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