Provider Demographics
NPI:1306819586
Name:FLORES, DEBORAH L (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:FLORES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W CARSON ST # 498
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2004
Mailing Address - Country:US
Mailing Address - Phone:310-222-3151
Mailing Address - Fax:310-328-7217
Practice Address - Street 1:1000 W CARSON ST # 498
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2004
Practice Address - Country:US
Practice Address - Phone:310-222-3151
Practice Address - Fax:310-328-7217
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA708902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A708900Medicaid
CAH28236Medicare UPIN
CAWA70890EMedicare ID - Type UnspecifiedPPIN
CA00A708900Medicaid
CAWA70890FMedicare ID - Type UnspecifiedPPIN