Organization
BALBOA THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SRI GOPAL (CEO)
(619) 294-7300
Entity
Organization
Contact information
Practice address
3969 4TH AVE STE 208, SAN DIEGO, CA 92103-3165
(619) 294-7300
Mailing address
3969 4TH AVE STE 208, SAN DIEGO, CA 92103-3165
(619) 294-7300
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
CA
Other
Enumeration date
09/14/2006
Last updated
08/22/2020
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