Individual
RICHARD GONSALVES BALELO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
400 CRAVEN RD, SAN MARCOS, CA 92078-4201
(710) 510-4032
(710) 510-5600
Mailing address
10894 KEMAH LN, SAN DIEGO, CA 92131-1320
(858) 271-4596
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT 16075
CA
Other
Enumeration date
06/18/2007
Last updated
12/01/2021
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