Provider Demographics
NPI:1629062435
Name:BALBAS, EDWARD ALBERT GUARIN (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD ALBERT
Middle Name:GUARIN
Last Name:BALBAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4942 ROAN CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-2445
Mailing Address - Country:US
Mailing Address - Phone:707-477-8452
Mailing Address - Fax:
Practice Address - Street 1:900 E WASHINGTON ST STE 300
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-8182
Practice Address - Country:US
Practice Address - Phone:909-333-6094
Practice Address - Fax:909-824-8234
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA890362081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA89036OtherMEDICAL LICENSE #
CA05808134OtherECFMG NUMBER