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Individual

LAURA LISA CEBALLOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1809 NATIONAL AVE, SAN DIEGO, CA 92113-2113
(619) 515-2300
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2300

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
C198539
CA
207V00000X
Obstetrics & Gynecology Physician
M8580
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201438301
TX
01
8CA111
BCBS
01
M8580
LIC
TX
Enumeration date
08/07/2007
Last updated
06/16/2025
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