Provider Demographics
NPI:1932422698
Name:FLORES, DEBBIE LO (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:LO
Last Name:FLORES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 CAMINO DE LA SIESTA STE 204
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3118
Mailing Address - Country:US
Mailing Address - Phone:858-514-3700
Mailing Address - Fax:
Practice Address - Street 1:5030 CAMINO DE LA SIESTA STE 204
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3118
Practice Address - Country:US
Practice Address - Phone:858-514-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1163363AM0700X
CAPA20216363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical