Provider Demographics
NPI:1154359271
Name:FLORES, CHRISTOPHER VEGA (MD)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:VEGA
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72780 COUNTRY CLUB DR STE 205
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-4150
Mailing Address - Country:US
Mailing Address - Phone:760-834-7987
Mailing Address - Fax:607-834-7988
Practice Address - Street 1:72780 COUNTRY CLUB DR STE 205
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4150
Practice Address - Country:US
Practice Address - Phone:760-834-7987
Practice Address - Fax:607-834-7988
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74415207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F71591OtherUPIN
F71591OtherUPIN
00G744150Medicare ID - Type Unspecified