Provider Demographics
NPI:1033578968
Name:FLORES, HECTOR DURAN
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:DURAN
Last Name:FLORES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3495 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:IONE
Mailing Address - State:CA
Mailing Address - Zip Code:95640-9613
Mailing Address - Country:US
Mailing Address - Phone:209-790-9265
Mailing Address - Fax:800-217-0876
Practice Address - Street 1:3495 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:IONE
Practice Address - State:CA
Practice Address - Zip Code:95640-9613
Practice Address - Country:US
Practice Address - Phone:209-790-9265
Practice Address - Fax:800-217-0876
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-20
Last Update Date:2016-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0000003690343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)