Provider Demographics
NPI:1528059276
Name:FLORES, JILL M (MD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:M
Last Name:FLORES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4058 WILLOWS RD
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-1668
Mailing Address - Country:US
Mailing Address - Phone:619-445-1188
Mailing Address - Fax:619-659-3140
Practice Address - Street 1:22 W 25TH ST. STE 101
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950
Practice Address - Country:US
Practice Address - Phone:619-427-3361
Practice Address - Fax:619-827-0539
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2024-06-04
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Provider Licenses
StateLicense IDTaxonomies
CAA77198207Q00000X
HIMD 13473207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HII41529Medicare UPIN