BALBOA NEPHROLOGY MEDICAL GROUP,INC. (NPI# 1598276404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598276404 |
| Entity Type | Organization |
| Organization Name | BALBOA NEPHROLOGY MEDICAL GROUP,INC. |
| Practice Address |
6402 El Cajon Blvd Ste 100 San Diego CA 92115-2645 |
| Mailing Address |
9610 Granite Ridge Dr Ste B San Diego CA 92123-2684 |
| Practice Telephone | 6195824490 |
| Practice Fax Number | 6195824737 |
| Mailing Telephone | 8588108000 |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2017-10-18 |
| Authorized Official Name | STEPHANIE WENCESLAO (CONTRACTS & CREDENTIALING ANALYST) |
| Authorized Official Telephone | 8588108025 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790962199 | Balboa Nephrology Medical Group,inc. | Internal Medicine | 790 W Orange Ave, Ste B, El Centro, CA 92243-3274 | 2008-01-28 |
| Street Address |
6402 EL CAJON BLVD STE 100 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92115-2645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790313922 | Mayra Ailed Bugarin | Student in an Organized Health Care Education/Training Program | City Heights Family Health Center 5454, El Cajon Blvd, San Diego, CA 92115 | 2020-04-01 |
| 1093369878 | Chang Liu | Counselor | 3539 College Avenue, San Diego, CA 92115 | 2019-07-30 |
| 1689238560 | Donia Ahadian | Student in an Organized Health Care Education/Training Program | City Heights Family Health Center, 5454 El Cajon Blvd, San Diego, CA 92115 | 2019-04-26 |
| 1780157859 | James Michael Sites | Military Health Care Provider | Uss Shoup Ddg 86, San Diego, CA 92115 | 2019-01-10 |
| 1780163006 | Marcos Luis Sandoval | Case Manager/Care Coordinator | 6224 El Cajon Blvd, Suite 17, San Diego, CA 92115 | 2018-08-08 |
| 1437651981 | Phyllis Lynette Pryor | Licensed Vocational Nurse | 4974 El Cajon Blvd Suite A, San Diego, CA 92115 | 2018-03-01 |
| 1982125605 | Ellen Medical Transport | Non-emergency Medical Transport (VAN) | 4587 Winona Ave #5, San Diego, CA 92115 | 2017-07-03 |
| 1992225296 | P'okot LLC | Non-emergency Medical Transport (VAN) | 5511 Adelaide Ave, 26, San Diego, CA 92115 | 2017-06-27 |
| 1578019840 | Alfred Zygmunt Nowak | Specialist/Technologist | 6663 Reservoir Ln, San Diego, CA 92115 | 2016-08-28 |
| 1639534183 | Kalkaal Financial Enterprise, LLC. | Non-emergency Medical Transport (VAN) | 5055 Collwood Blvd., Unit 108, San Diego, CA 92115 | 2015-12-29 |
| Find all providers in zip 92115 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275006173 | Balboa Surgical Institute, Inc. | Clinic/Center | 7625 Mesa College Drive, Suite 315a, San Diego, CA 92111-5343 | 2019-01-03 |
| 1316462377 | Ucsd Surgical Center of San Diego, LLC | Clinic/Center | 4910 Directors Pl Ste 100, San Diego, CA 92121-3814 | 2017-08-10 |
| 1710325220 | Carmel Valley Surgical Center | Clinic/Center | 11943 El Camino Real, Suite 100, San Diego, CA 92130-2597 | 2013-06-06 |
| 1346515095 | Medical Acadamy of Hawaii and Anatomical Learning Orginization | Clinic/Center | 5286 Eastgate Mall, San Diego, CA 92121-2815 | 2012-03-14 |
| 1245534460 | The Hilinski Ambulatory Surgery Center | Clinic/Center | 3720 4th Avenue, San Diego, CA 92103 | 2011-01-03 |
| 1538463153 | La Jolla Surgery Center | Clinic/Center | 4510 Executive Dr Ste 200a, San Diego, CA 92121-3023 | 2010-12-23 |
| 1922324177 | Surgical Center of San Diego, LLC | Clinic/Center | 4910 Directors Place, Suite 100, San Diego, CA 92121-3814 | 2010-04-13 |
| 1194968677 | Professional Surgicenter, Inc | Clinic/Center | 4510 Executive Dr Ste 105a, San Diego, CA 92121-3022 | 2009-04-13 |
| 1578729539 | The Reservoir Physicans Surgery Center, LLC | Clinic/Center | 6716 Alvarado Rd, San Diego, CA 92120 | 2008-07-30 |
| 1528130879 | Pacific Surgical Institute of Pain Management | Clinic/Center | 3703 Camino Del Rio South, Suite 101, San Diego, CA 92108 | 2006-11-14 |
| Find all providers in SAN DIEGO | ||||
Please comment or provide details below to improve the information on BALBOA NEPHROLOGY MEDICAL GROUP,INC..
| 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.