Provider Demographics
NPI:1881765592
Name:JEFFREY W. FLORES CHIROPRACTIC INC
Entity type:Organization
Organization Name:JEFFREY W. FLORES CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:559-435-3331
Mailing Address - Street 1:6759 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-3934
Mailing Address - Country:US
Mailing Address - Phone:559-435-3331
Mailing Address - Fax:559-435-3222
Practice Address - Street 1:6759 N 1ST ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-3934
Practice Address - Country:US
Practice Address - Phone:559-435-3331
Practice Address - Fax:559-435-3222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24272111N00000X
CA22668111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0226680Medicare ID - Type Unspecified
CADC0226680Medicare UPIN