Individual
LARRY CLAY BALLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3811 VALLEY CENTRE DR, SAN DIEGO, CA 92130-3318
(858) 554-9300
Mailing address
FILE# 54433, LOS ANGELES, CA 90074-0001
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E4626
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E46260
—
CA
Enumeration date
05/24/2006
Last updated
06/24/2009
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