Provider Demographics
NPI:1669492948
Name:FLOWERS, CALVIN J (MD)
Entity Type:Individual
Prefix:
First Name:CALVIN
Middle Name:J
Last Name:FLOWERS
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 1:47040 WASHINGTON ST STE 3202
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-2628
Mailing Address - Country:US
Mailing Address - Phone:760-799-8931
Mailing Address - Fax:800-886-6465
Practice Address - Street 1:47040 WASHINGTON ST STE 3202
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-2628
Practice Address - Country:US
Practice Address - Phone:760-799-8931
Practice Address - Fax:800-886-6465
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG775082084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ48259OtherMEDICAL LICENSE
CA00G775081Medicare ID - Type Unspecified