Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 32173 | CA |
NPI | 1063786416 |
---|---|
Provider Name | Jacinto M Flores-Alvarez |
First Address | Coto De Caza, CA 92679 |
Second Address | Irvine, CA 92618-6705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2012 |
Last Update Date | 08/03/2021 |