Provider Demographics
NPI:1235358979
Name:FLORES, VICTOR MANUEL (DC)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:MANUEL
Last Name:FLORES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23974 ALISO CREEK RD # 275
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-3908
Mailing Address - Country:US
Mailing Address - Phone:949-495-8200
Mailing Address - Fax:949-495-8004
Practice Address - Street 1:28940 GOLDEN LANTERN
Practice Address - Street 2:SUITE I
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1500
Practice Address - Country:US
Practice Address - Phone:949-495-8200
Practice Address - Fax:949-495-8004
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28370111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor