Provider Demographics
NPI:1407944218
Name:BALBAS, ANGELITA GUARIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELITA
Middle Name:GUARIN
Last Name:BALBAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:901 NEVIN AVE
Mailing Address - Street 2:PHYSICAL MEDICINE/SPINE CLINIC
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94801-3143
Mailing Address - Country:US
Mailing Address - Phone:510-307-1661
Mailing Address - Fax:510-307-1664
Practice Address - Street 1:901 NEVIN AVE
Practice Address - Street 2:PHYSICAL MEDICINE/SPINE CLINIC
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-3143
Practice Address - Country:US
Practice Address - Phone:510-307-1661
Practice Address - Fax:510-307-1664
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA833542081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A833540Medicaid
7146810OtherAETNA
I64582Medicare UPIN
CA00A833540Medicaid
7146810OtherAETNA
CAWA83354DMedicare PIN