Individual
GINA M TORRES BALSAMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
259 BLUEBERRY HILL RD, EL PRADO, NM 87529-7305
(575) 758-5858
Mailing address
PO BOX 3141, CARLSBAD, NM 88221-3141
(575) 725-5552
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2010-0048
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83383778
—
NM
05
—
N0022763
—
NM
01
—
NMAAA0219
MEDICARE PTAN
NM
Enumeration date
09/09/2010
Last updated
03/10/2026
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