Individual
DENNIS TERRANCE BALOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6403 COYLE AVE STE 170, CARMICHAEL, CA 95608-0363
(916) 965-4000
(916) 965-4813
Mailing address
6403 COYLE AVE STE 170, CARMICHAEL, CA 95608-0363
(916) 965-4000
(916) 965-4813
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA22836
CA
363AS0400X
Surgical Physician Assistant
Primary
PA22836
CA
Other
Enumeration date
04/22/2013
Last updated
01/03/2022
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