BALBOA NEPHROLOGY MEDICAL GROUP INC (NPI# 1316997505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316997505 |
| Entity Type | Organization |
| Organization Name | BALBOA NEPHROLOGY MEDICAL GROUP INC |
| Practice Address |
9610 Granite Ridge Dr Ste B San Diego CA 92123-2684 |
| Practice Telephone | 8588108000 |
| Practice Fax Number | 8582681911 |
| Mailing Telephone | 8588108000 |
| Mailing Fax Number | 8582681911 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2016-09-29 |
| Authorized Official Name | DR. DYLAN L STEER (MEDICAL CORP. CEO) |
| Authorized Official Telephone | 8588108000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 204F00000X | Transplant Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE PTAN, SO CA | W1487 | 01 |
| CA | MEDICARE PTAN ORANGE COUNTY | CB251966 | 01 |
| CA | MEDICARE PTAN, NO CA | ZZZ04938Z | 01 |
| Street Address |
9610 GRANITE RIDGE DR STE B |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-2684 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194241224 | Christina Van Ert | Physical Therapist | 9610 Granite Ridge Dr, San Diego, CA 92123-2684 | 2017-08-21 |
| 1396285920 | Rajan Bains | Physical Therapist | 9610 Granite Ridge Dr, San Diego, CA 92123-2684 | 2017-03-01 |
| 1891158549 | Sharp Rees-stealy Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 9610 Granite Ridge Dr, San Diego, CA 92123-2684 | 2016-03-31 |
| 1467888065 | Jesse James Simmons | Physical Therapist | 9610 Granite Ridge Dr, Suite C, San Diego, CA 92123-2684 | 2013-09-16 |
| 1730485855 | Alison Lou Adamczyk | Chiropractor | 9610 Granite Ridge Dr, Suite C, San Diego, CA 92123-2684 | 2011-02-08 |
| 1053629584 | Keri Von Kalinowski | Physical Therapist | 9610 Granite Ridge Dr, San Diego, CA 92123-2684 | 2010-09-17 |
| 1699090779 | Miriam Eneida Cruz | Occupational Therapist | 9610 Granite Ridge Dr, San Diego, CA 92123-2684 | 2010-04-01 |
| 1982832945 | Bianca Ashley Tribuzio | Physical Medicine & Rehabilitation | 9610 Granite Ridge Dr, San Diego, CA 92123-2684 | 2009-06-29 |
| 1295974673 | Erin Jean Stone | Physical Therapist | 9610 Granite Ridge Dr, San Diego, CA 92123-2684 | 2009-02-09 |
| 1316116494 | Hassia Alice Orgel | Allergy & Immunology | 9610 Granite Ridge Dr, Suite B, San Diego, CA 92123-2684 | 2008-02-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184019051 | Viet Duy Nguyen | Internal Medicine | 4060 Fourth Ave Ste 220, San Diego, CA 92103-2120 | 2015-03-30 |
| 1659624732 | Dinna Cruz | Internal Medicine | 200 W Arbor Dr # Mc8201, Ucsd Medical Group - Mc 8201, San Diego, CA 92103-1911 | 2012-10-26 |
| 1770834319 | Coleman Albert Mosley Jr. | Internal Medicine | 1855 Lyndon Rd, San Diego, CA 92103-1644 | 2012-09-22 |
| 1205046182 | Shaunak Vijay Rana | Internal Medicine | 1804 Garnet Ave, #721, San Diego, CA 92109-3352 | 2007-05-22 |
| 1811043607 | Robert W Steiner | Internal Medicine | 4168 Front Street, Mc 8781, San Diego, CA 92103-8781 | 2007-01-26 |
| 1437217841 | Samir S Shah | Internal Medicine | 220 W. Arbor Dr. Dept 8781, San Diego, CA 92103-8781 | 2006-12-05 |
| 1609983253 | Robyn Alice Cunard | Internal Medicine | 151 Mail Code, 3350 La Jolla Village Drive, San Diego, CA 92161-0001 | 2006-08-23 |
| 1356312219 | Shagun Chopra-sonthalia | Internal Medicine | 3500 Bob Wilson Dr, San Diego, CA 92121-2666 | 2006-01-30 |
| 1043215502 | Alfredo B. Tiu | Internal Medicine | 200 W Arbor Dr, Owen Clinic, San Diego, CA 92103-9001 | 2005-06-20 |
| 1760487458 | Jadwiga M Alexiewicz | Internal Medicine | 7910 Frost St, Ste 220, San Diego, CA 92123-2771 | 2005-06-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.