Organization
SHANA L BALLOW DO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANA LYNN BALLOW DO (PRESIDENT)
(818) 640-3552
Entity
Organization
Contact information
Practice address
1044 S FAIR OAKS AVE, SUITE 101, PASADENA, CA 91105-2622
(626) 768-4415
(626) 403-0321
Mailing address
2730 WILSHIRE BVLD, SUITE 400, SANTA MONICA, CA 90403-4751
(626) 768-4415
(626) 403-0321
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
20A10299
CA
Other
Enumeration date
08/28/2012
Last updated
08/31/2012
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