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Organization
BALBOA SURGICAL ASSOCIATES INC.
Active
Organization
BALBOA SURGICAL ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA HART (BILLING MANAGER)
(949) 872-5192
Entity
Organization
Contact information
Practice address
2501 E CHAPMAN AVE STE 220, FULLERTON, CA 92831-3108
(949) 872-5192
Mailing address
129 LESSAY, NEWPORT COAST, CA 92657-1043
(949) 872-5192
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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