Provider Demographics
NPI:1154407781
Name:FLODIUS, JAM (DC)
Entity type:Individual
Prefix:DR
First Name:JAM
Middle Name:
Last Name:FLODIUS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 VALENCIA ST
Mailing Address - Street 2:SUITE # 102
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4423
Mailing Address - Country:US
Mailing Address - Phone:415-821-0600
Mailing Address - Fax:415-282-3273
Practice Address - Street 1:1580 VALENCIA ST
Practice Address - Street 2:SUITE # 102
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4423
Practice Address - Country:US
Practice Address - Phone:415-821-0600
Practice Address - Fax:415-282-3273
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30304111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor