Provider Demographics
NPI:1154301935
Name:FLYNN, NEIL MUNRO (MD, MPH, ABPM)
Entity Type:Individual
Prefix:MR
First Name:NEIL
Middle Name:MUNRO
Last Name:FLYNN
Suffix:
Gender:M
Credentials:MD, MPH, ABPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3647 49TH STREET
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817
Mailing Address - Country:US
Mailing Address - Phone:916-452-1068
Mailing Address - Fax:916-469-9415
Practice Address - Street 1:3647 49TH STREET
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-452-1068
Practice Address - Fax:916-469-9415
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G276310207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G276310OtherMEDI-CAL
CA00G276310Medicare ID - Type Unspecified
CA00G276310OtherMEDI-CAL