Provider Demographics
NPI:1851485049
Name:GEOLA, FLOR (MD)
Entity Type:Individual
Prefix:DR
First Name:FLOR
Middle Name:
Last Name:GEOLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11600 WILSHIRE BLVD.
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025
Mailing Address - Country:US
Mailing Address - Phone:310-477-0501
Mailing Address - Fax:310-473-5266
Practice Address - Street 1:11600 WILSHIRE BLVD.
Practice Address - Street 2:SUITE 210
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025
Practice Address - Country:US
Practice Address - Phone:310-477-0501
Practice Address - Fax:310-473-5266
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31360207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOA313600Medicaid
CAA31360Medicare ID - Type Unspecified
CAOOA313600Medicaid