Provider Demographics
NPI:1346298478
Name:BALLERINI, DANA JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:JOSEPH
Last Name:BALLERINI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1442 IRVINE BLVD
Mailing Address - Street 2:101
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3801
Mailing Address - Country:US
Mailing Address - Phone:714-544-3900
Mailing Address - Fax:714-544-2731
Practice Address - Street 1:1442 IRVINE BLVD
Practice Address - Street 2:101
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3801
Practice Address - Country:US
Practice Address - Phone:714-544-3900
Practice Address - Fax:714-544-2731
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor