Provider Demographics
NPI:1114392933
Name:FLEXOGENIX, INC.
Entity Type:Organization
Organization Name:FLEXOGENIX, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CBDO
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:WHALEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:213-622-6010
Mailing Address - Street 1:1000 S HOPE STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-4057
Mailing Address - Country:US
Mailing Address - Phone:213-622-6010
Mailing Address - Fax:213-622-6011
Practice Address - Street 1:21250 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5508
Practice Address - Country:US
Practice Address - Phone:213-622-6010
Practice Address - Fax:213-622-6011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-04
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6885720003Medicare NSC
CAHI609AMedicare PIN