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General NPI Number Information
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NPI Number | 1942617089
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Entity Type | Individual
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Provider Name | RONALDO FLORES P.A.
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Gender | Male
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Dates
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Enumeration Date | 07/22/2014
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 2025 MORSE AVE
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City | SACRAMENTO
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State | CA
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Zip | 95825-2115
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Country | US
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Telephone | 916-973-5490
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Fax |
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Provider Business Mailing Address
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Address Line | 1528 EUREKA RD STE 103
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City | ROSEVILLE
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State | CA
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Zip | 95661-3047
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Country | US
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Telephone | 916-461-4543
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Fax | 916-771-6338
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 22209
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License Number State | CA
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