Organization
SAN MARTIN DEPORRES MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACOB N FLORES M.D. (OWNER)
(714) 953-6430
Entity
Organization
Contact information
Practice address
1701 E MCFADDEN AVE, UNIT D, SANTA ANA, CA 92705-4647
(714) 953-6430
Mailing address
1701 E MCFADDEN AVE, UNIT D, SANTA ANA, CA 92705-4647
(714) 953-6430
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
W11619
CA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
A60865
CA
Other
Enumeration date
04/02/2007
Last updated
03/09/2011
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