Provider Demographics
NPI:1457985533
Name:QUALITY OF LIFE HEALTHCARE INC
Entity type:Organization
Organization Name:QUALITY OF LIFE HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLERINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-544-3900
Mailing Address - Street 1:1442 IRVINE BLVD
Mailing Address - Street 2:
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:
Practice Address - Street 1:1442 IRVINE BLVD
Practice Address - Street 2:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty