Individual
LEIGH ANN BALLOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11234 ANDERSON ST, RM 2562B, LOMA LINDA, CA 92354-2804
(909) 558-6386
Mailing address
25455 BARTON RD, SUITE 108-A, LOMA LINDA, CA 92354-3128
(909) 558-6386
(909) 558-6206
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA16765
CA
Other
Enumeration date
07/14/2005
Last updated
07/08/2007
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