Individual
ANDREW MICHAEL BALLESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 732-0543
Mailing address
101 THE CITY DR S, ORANGE, CA 92868-3201
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568191799
—
CA
Enumeration date
06/04/2022
Last updated
04/07/2026
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