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Organization
JODY BALLOCH MD INC
Active
Organization
JODY BALLOCH MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODY BALLOCH MD (PHYSICIAN/OWNER)
(805) 482-1416
Entity
Organization
Contact information
Practice address
3801 LAS POSAS RD # 106A, CAMARILLO, CA 93010-1427
(805) 482-1416
(805) 389-3047
Mailing address
3801 LAS POSAS RD # 106A, CAMARILLO, CA 93010-1427
(805) 482-1416
(805) 389-3047
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W13368
UPIN GROUP#
CA
01
—
ZZZ482532
BLUE SHIELD
CA
Enumeration date
09/26/2006
Last updated
04/23/2008
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