Provider Demographics
NPI:1215125604
Name:FLORES, STEPHEN BEDE JR
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:BEDE
Last Name:FLORES
Suffix:JR
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 1:6036 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-1566
Mailing Address - Country:US
Mailing Address - Phone:909-248-8274
Mailing Address - Fax:
Practice Address - Street 1:2200 E ROUTE 66
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4659
Practice Address - Country:US
Practice Address - Phone:626-859-2089
Practice Address - Fax:626-859-6537
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner