Provider Demographics
NPI:1114400959
Name:DI FLAURO, PAUL O'BRIEN (NP)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:O'BRIEN
Last Name:DI FLAURO
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 FAIRMOUNT AVE STE 412
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3154
Mailing Address - Country:US
Mailing Address - Phone:626-898-9797
Mailing Address - Fax:626-737-2685
Practice Address - Street 1:800 FAIRMOUNT AVE STE 412
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3154
Practice Address - Country:US
Practice Address - Phone:626-898-9797
Practice Address - Fax:626-737-2685
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA808423207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine