Individual
CEATTLE BALCORTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
NAS LEMOORE, K ST, LEMOORE, CA 93245
(559) 988-4000
Mailing address
K ST, LEMOORE, CA 93245
(559) 988-4000
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
OS20418
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2022
Last updated
06/07/2024
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