Provider Demographics
NPI:1548494164
Name:FLORES, GENE P (MPT)
Entity type:Individual
Prefix:
First Name:GENE
Middle Name:P
Last Name:FLORES
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:25115 AVENUE STANFORD STE B135
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1290
Mailing Address - Country:US
Mailing Address - Phone:661-250-9940
Mailing Address - Fax:661-250-9959
Practice Address - Street 1:3753 E THOUSAND OAKS BLVD
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3607
Practice Address - Country:US
Practice Address - Phone:805-497-7900
Practice Address - Fax:805-497-0720
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT29828225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist