Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 20A8607 | CA |
NPI | 1659578672 |
---|---|
Provider Name | Dr. K. Ball |
First Address | Loma Linda, CA 92354-0853 |
Second Address | Paradise, CA 95969-6710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 23/12/2009 |