Provider Demographics
NPI:1124758644
Name:FLORES, ELMER MAURICIO
Entity type:Individual
Prefix:
First Name:ELMER
Middle Name:MAURICIO
Last Name:FLORES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15000 DOWNEY AVE UNIT 108
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-4598
Mailing Address - Country:US
Mailing Address - Phone:562-331-4683
Mailing Address - Fax:
Practice Address - Street 1:2629 CLARENDON AVE FL 2
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4119
Practice Address - Country:US
Practice Address - Phone:323-584-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program