Provider Demographics
NPI:1457674178
Name:FLORES, GINA CELESTE (C-PNP)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:CELESTE
Last Name:FLORES
Suffix:
Gender:F
Credentials:C-PNP
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Other - First Name:
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Mailing Address - Street 1:4650 SUNSET BLVD #100
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027
Mailing Address - Country:US
Mailing Address - Phone:323-361-5018
Mailing Address - Fax:323-361-6462
Practice Address - Street 1:4650 SUNSET BLVD #100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027
Practice Address - Country:US
Practice Address - Phone:323-361-5018
Practice Address - Fax:323-361-6462
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA642173363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics