Provider Demographics
NPI:1730428004
Name:JAMES H FLORES JR MD INC
Entity type:Organization
Organization Name:JAMES H FLORES JR MD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:310-544-0828
Mailing Address - Street 1:827 DEEP VALLEY DR
Mailing Address - Street 2:SUITE #310
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3647
Mailing Address - Country:US
Mailing Address - Phone:310-544-0828
Mailing Address - Fax:310-377-5536
Practice Address - Street 1:827 DEEP VALLEY DR
Practice Address - Street 2:SUITE #310
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3647
Practice Address - Country:US
Practice Address - Phone:310-544-0828
Practice Address - Fax:310-377-5536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG067438261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F11432OtherUPIN
1720166481OtherNPI