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Individual

IDA BALIGOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CLINIC NURSE

Contact information

Practice address
40910 FREMONT BLVD, FREMONT, CA 94538-4375
(510) 770-8040
Mailing address
38043 MILLER PL, FREMONT, CA 94536-3825
(408) 674-8112

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
345998
CA

Other

Enumeration date
02/10/2025
Last updated
02/10/2025
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