Organization
CHRISTIAN NATIONAL CHURCH
Active
Other names
Presidential service badge holder agency, Chaplain serve and protect, Presidential service officer agency, national association of law enforcement explorers of the christian nat, the firm, National Association of law enforcement explorers agency, diplomatic immunity agency, diplomatic security services-Special Agent Physician and Pharmacy, Diplomatic security services age cy, Diplomatic security services provider and pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYANT LAMONT BALL MD (OFFICER/PROVIDER)
(425) 387-7233
Entity
Organization
Contact information
Practice address
1350 E CHAPMAN AVE, FULLERTON, CA 92834-7400
(425) 387-7233
Mailing address
GENERAL DELIVERY, FULLERTON, CA 92834-9999
(425) 387-7233
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
—
—
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105384465
—
CA
Enumeration date
01/31/2020
Last updated
05/13/2021
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