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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