Individual
BENITA BALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17581 SULTANA ST, HESPERIA, CA 92345-6552
(760) 244-5579
Mailing address
4950 REYES ADOBE RD, AGOURA HILLS, CA 91301-2023
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95028802
CA
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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