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Amanda Ballard, PA-C

Physician Assistant in Pomona, CA. Individual provider (NPI-1).

NPI number1164983375
StatusActive
Last updated in NPPESJun 4, 2020

Details

NPI
1164983375
Entity type
Individual (NPI-1)
Name
Amanda Ballard
Credential
PA-C
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 29, 2019
Certification date
Jun 4, 2020
Last updated
Jun 4, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant58016CAYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

160 E Artesia St Ste 255
Pomona, CA 91767-2921

Phone 909-596-4346 · Fax 909-596-4344

Mailing address

160 E Artesia St Ste 255
Pomona, CA 91767-2921

Phone 909-596-4346

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