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NPI Code Detail

MEDICARE: MR. CARLOS FLORES PA

MEDICARE: MR. CARLOS FLORES PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA12771CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00072073OTHERCAMEDICARE RAILROAD

General Provider Information

NPI Number : 1275635633
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CARLOS FLORES PA
Provider Business Mailing Address
First Line : PO BOX 1139
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93302-1139
Country : US
Telephone Number : 661-371-2796
Fax Number : 661-438-1746
Provider Business Practice Location Address
First Line : 5401 WHITE LN
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93309-6279
Country : US
Telephone Number : 661-836-4000
Fax Number : 661-847-4097
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2006
Last Update Date : 01/16/2017

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