Provider Demographics
NPI:1407880040
Name:FLORES, CARLOS A (MD)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:A
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14673 PARTHENIA ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-2991
Mailing Address - Country:US
Mailing Address - Phone:818-785-7300
Mailing Address - Fax:818-785-2775
Practice Address - Street 1:14673 PARTHENIA ST STE 101
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-2991
Practice Address - Country:US
Practice Address - Phone:818-785-7300
Practice Address - Fax:818-785-2775
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41653174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A416531Medicaid
CA00A416530Medicaid
CA00A416531Medicaid
CA00A416530Medicaid