Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E3667 | CA |
Y | 222Z00000X | Podiatrist | E3667 | CA |
NPI | 1033117106 |
---|---|
Provider Name | K. David Flora |
First Address | Tulare, CA 93274-2251 |
Second Address | Tulare, CA 93274-2251 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 31/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E36670 | MEDI-CAL ID # (01) | CA |
BF2371994 | DEA LICENSE # (01) | CA |
RHC140182 | RADIOGRAPHY LIC # (01) | CA |
U01893 | (02) | CA |