1265708531 NPI number — JOHANA ESTHER FLORES RIOS M.D.

Table of content: JOHANA ESTHER FLORES RIOS M.D. (NPI 1265708531)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265708531 NPI number — JOHANA ESTHER FLORES RIOS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FLORES RIOS
Provider First Name:
JOHANA
Provider Middle Name:
ESTHER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLORES RIOS
Provider Other First Name:
JOHANA
Provider Other Middle Name:
ESTHER
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1265708531
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3727 W. 6TH ST.
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
213-637-1070
Provider Business Mailing Address Fax Number:
213-251-8647

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3727 W. 6TH ST.
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-637-1070
Provider Business Practice Location Address Fax Number:
213-251-8647
Provider Enumeration Date:
03/30/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  A122420 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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