Individual
ROBERT W GORMAN BALASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
NAVAL MEDICAL CTR, 34800 BOB WILSON DRIVE, SAN DIEGO, CA 92134-5000
(619) 532-6666
Mailing address
NAVAL MEDICAL CTR, 34800 BOB WILSON DRIVE, SAN DIEGO, CA 92134-5000
(619) 532-6666
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/27/2006
Last updated
01/14/2011
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