Individual
MR. SAMUEL CYRIL BALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
815 POLLARD RD, ATTN: CGOPS, LOS GATOS, CA 95032-1438
(408) 378-6545
(408) 378-6550
Mailing address
815 POLLARD RD, ATTN: CGOPS, LOS GATOS, CA 95032-1438
(408) 378-6545
(408) 378-6550
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
G21751
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G217514
MEDICARE PIN
CA
05
—
GR0101630
—
CA
Enumeration date
07/15/2006
Last updated
07/09/2007
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