Organization
IBALANCEME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALDO SAN JOSE (OWNER)
(323) 333-4366
Entity
Organization
Contact information
Practice address
5544 E 2ND ST, LONG BEACH, CA 90803-3924
(323) 333-4366
Mailing address
300 N IRVING BLVD, LOS ANGELES, CA 90004-1508
(323) 333-4366
(323) 723-3967
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
15761
CA
Other
Enumeration date
04/19/2017
Last updated
04/19/2017
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