Individual
SHAILESH BALASUBRAMANIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1223 16TH ST STE 3400, SANTA MONICA, CA 90404-1279
(310) 449-0939
(424) 259-7790
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8771
(310) 301-8771
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
274282
NY
207RP1001X
Pulmonary Disease Physician
Primary
A168744
CA
Other
Enumeration date
04/12/2010
Last updated
11/20/2020
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