Provider Demographics
NPI:1285153882
Name:FLINDERS PHYSICIANS GROUP INC
Entity type:Organization
Organization Name:FLINDERS PHYSICIANS GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AZARKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-408-7096
Mailing Address - Street 1:319 N BROADWAY APT 108
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-2850
Mailing Address - Country:US
Mailing Address - Phone:310-408-7096
Mailing Address - Fax:
Practice Address - Street 1:319 N BROADWAY APT 215
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-2850
Practice Address - Country:US
Practice Address - Phone:310-408-7096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA116986261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherIRS