Individual
DR. JOHN R BALLENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
777 CAMPUS COMMONS RD, SUITE 120, SACRAMENTO, CA 95825-8309
(916) 929-8564
(916) 929-4529
Mailing address
777 CAMPUS COMMONS RD, SUITE 120, SACRAMENTO, CA 95825-8309
(916) 929-8564
(916) 929-4529
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G43354
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110060884
RAILROAD MEDICARE
—
05
—
GR0015060
—
CA
Enumeration date
07/27/2006
Last updated
07/18/2012
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