Provider Demographics
NPI:1609912369
Name:HYACINTH, FLORA (DC)
Entity Type:Individual
Prefix:DR
First Name:FLORA
Middle Name:
Last Name:HYACINTH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6280 JACKSON DR
Mailing Address - Street 2:STE. 4C
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-3434
Mailing Address - Country:US
Mailing Address - Phone:619-804-5144
Mailing Address - Fax:619-464-4378
Practice Address - Street 1:6280 JACKSON DR
Practice Address - Street 2:STE. 4C
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-3434
Practice Address - Country:US
Practice Address - Phone:619-804-5144
Practice Address - Fax:619-464-4378
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD.C. 29067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor