Provider Demographics
NPI:1457502817
Name:FLH PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:FLH PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:S
Authorized Official - Last Name:MUIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-200-4629
Mailing Address - Street 1:620 NEWPORT CENTER DR
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-6420
Mailing Address - Country:US
Mailing Address - Phone:949-200-4629
Mailing Address - Fax:816-719-4255
Practice Address - Street 1:620 NEWPORT CENTER DR
Practice Address - Street 2:SUITE 1100
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-6420
Practice Address - Country:US
Practice Address - Phone:949-200-4629
Practice Address - Fax:816-719-4255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97068261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health