Organization
BALWIN PARK MEDICAL GROUP, INC.
Active
Other names
Balwin Park Medical Group, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
ERRAJITH BERTRAND R DE SILVA MEDICAL DOCTOR (MEDICAL DIRECTOR)
(714) 673-2603
Entity
Organization
Contact information
Practice address
14652 PACIFIC AVE, BALDWIN PARK, CA 91706-5333
(626) 337-1360
(323) 962-1375
Mailing address
14652 PACIFIC AVE, BALDWIN PARK, CA 91706-5333
(626) 337-1360
(626) 962-1375
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/11/2020
Last updated
11/15/2020
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