Provider Demographics
NPI:1194183087
Name:BALL, BENJAMIN ZACHARY (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:ZACHARY
Last Name:BALL
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:255 E BONITA AVE BLDG 9
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-1923
Mailing Address - Country:US
Mailing Address - Phone:909-450-0369
Mailing Address - Fax:909-450-0366
Practice Address - Street 1:255 E BONITA AVE BLDG 9
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-1923
Practice Address - Country:US
Practice Address - Phone:099-450-0369
Practice Address - Fax:909-450-0366
Is Sole Proprietor?:No
Enumeration Date:2016-02-05
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA147883207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery