Individual
DR. KENNETH BALLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
191 S BUENA VISTA ST, STE. 215, BURBANK, CA 91505-4554
(818) 295-6944
(818) 295-6948
Mailing address
777 FLOWER ST, STE A, GLENDALE, CA 91201-3000
(818) 637-2000
(818) 242-8761
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G29221
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G409450
—
CA
Enumeration date
06/01/2005
Last updated
04/14/2011
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