Organization
NAVAL HOSPITAL BALBOA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA A DAVIS (39/STUDENT)
(619) 532-5829
Entity
Organization
Contact information
Practice address
34800 BOB WILSON DR, BLDG 1 SUITE 207, SAN DIEGO, CA 92134-1207
(619) 532-5829
Mailing address
34800 BOB WILSON DR, BLDG 1 SUITE 207, SAN DIEGO, CA 92134-1207
(619) 532-5829
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39
MEDI-CAL/MEDICARE
CA
Enumeration date
10/16/2009
Last updated
10/16/2009
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