Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | A83354 | CA |
NPI | 1407944218 |
---|---|
Provider Name | Dr. Angelita Guarin Balbas |
First Address | Richmond, CA 94801-3143 |
Second Address | Richmond, CA 94801-3143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A833540 | (05) | CA |
7146810 | AETNA (01) | |
I64582 | (02) |