Provider Demographics
NPI:1881601383
Name:FLORES, BYRON (MD)
Entity type:Individual
Prefix:DR
First Name:BYRON
Middle Name:
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BYRON
Other - Middle Name:
Other - Last Name:FLORES SOLORZANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8730 OLAND DR
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-2813
Mailing Address - Country:US
Mailing Address - Phone:213-215-1506
Mailing Address - Fax:
Practice Address - Street 1:928 N SAN FERNANDO BLVD STE J-185
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-4350
Practice Address - Country:US
Practice Address - Phone:213-215-1506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52173208D00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG04288Medicare UPIN