Individual provider Active NPI

Edgar Flores, MD

  • Legal Medicine
  • Fullerton, CA
National Provider Identifier
1992857239
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
A78642 Issued in CA
Practice address
50I S Brookhurst Rd
Fullerton, CA 92833
Phone
(714) 870-0717
Fax
(714) 870-5468
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X A78642 CA Primary

Addresses

Primary practice location

50I S Brookhurst Rd
Fullerton, CA 92833

Mailing address

50I South Brookhurst Rd
Fullerton, CA 92833
Phone (714) 870-0717

Other identifiers 1

IdentifierTypeStateIssuer
00A786420MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041105001029 CA Practitioner - Pediatric MedicinePractitioner - Internal Medicine 0749243103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
University of Southern California Keck School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

501 S Brookhurst Rd
Fullerton, CA 92833-3207
Phone (714) 870-0717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A78642CAMDLegal Medicine

Practice roles (4 of 5)

OrganizationSpecialtyStatusNew patients
Reproductive Health Care Center CurrentSince Apr 3, 2004 Accepting new patients
Anaheim Global Medical Center, Inc Past Accepting new patients
Seirra Health Center Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations

501 S Brookhurst Rd
Fullerton, CA 92833
Phone (714) 870-0717

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1992857239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50I SOUTH BROOKHURST RD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "92833",
            "telephone_number": "714-870-0717",
            "fax_number": "714-870-5468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50I S BROOKHURST RD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "92833",
            "telephone_number": "714-870-0717",
            "fax_number": "714-870-5468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "EDGAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "A78642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A786420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.