Provider Demographics
NPI:1750718680
Name:FLORES, RIZALIE SUBIDA (RNP)
Entity type:Individual
Prefix:
First Name:RIZALIE
Middle Name:SUBIDA
Last Name:FLORES
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 CESAR CHAVEZ AVE. 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90063-2213
Mailing Address - Country:US
Mailing Address - Phone:323-980-8404
Mailing Address - Fax:323-980-8405
Practice Address - Street 1:2080 CENTURY PARK E.
Practice Address - Street 2:#507
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2011
Practice Address - Country:US
Practice Address - Phone:310-553-1200
Practice Address - Fax:310-553-1216
Is Sole Proprietor?:No
Enumeration Date:2013-10-10
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA481776363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily