| Doctor Name: | MR. ELADIO DIESTO FLORES |
| NPI Number: | 1023202579 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 33673 |
| Business Practice Address: | 2920 Westminster Ave Seal Beach, CA - 907405305 |
| Business Phone Number: | 5625948600 |
| Business Fax Number: | 5625944599 |
| Mailing Address: | 8352 Yorkshire Ave, ANAHEIM |
| State: | CA |
| Postal Code: | 928046769 |
| Phone Number: | 5623036207 |
| Fax Number: | |
| NPI Enumeration Date: | 08/28/2007 |
| NPI Last Update Date: | 08/28/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 33673 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |