Organization
GANAPATHY BALA MD LLC
Active
Organization
GANAPATHY BALA MD LLC
Active
Other names
ALLERGY AND ASTHMA CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
GANAPATHY BALA M.D. (OWNER)
(719) 561-9757
Entity
Organization
Contact information
Practice address
1315 S PUEBLO BLVD, PUEBLO, CO 81005-2191
(719) 561-9757
(719) 561-9764
Mailing address
1315 S PUEBLO BLVD, PUEBLO, CO 81005-2191
(719) 561-9757
(719) 561-9764
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
36577
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07835744
—
CO
Enumeration date
08/05/2006
Last updated
12/09/2015
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