Individual
CHARLES HUNT BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
12742 LIMONITE AVE, EASTVALE, CA 92880-9630
(951) 739-2712
Mailing address
12742 LIMONITE AVE, EASTVALE, CA 92880-9630
(951) 739-2712
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A10039
CA
207Q00000X
Family Medicine Physician
DOS735
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ31887Z
SITE ZZZ
CA
Enumeration date
01/30/2007
Last updated
07/30/2025
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