Robert W Gorman Balasco, IDC
Military Health Care Provider, Independent Duty Corpsman in San Diego, CA. Individual provider (NPI-1).
NPI number1821189499
StatusActive
Last updated in NPPESJan 14, 2011
Details
- NPI
- 1821189499
- Entity type
- Individual (NPI-1)
- Name
- Robert W Gorman Balasco
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 27, 2006
- Last updated
- Jan 14, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1710I1002X | Military Health Care Provider, Independent Duty Corpsman | – | – | Yes |
Other names
- Robert W Gorman (Former Name)
Practice location
Naval Medical Ctr34800 Bob Wilson Drive
San Diego, CA 92134-5000
Phone 619-532-6666
Mailing address
Naval Medical Ctr34800 Bob Wilson Drive
San Diego, CA 92134-5000
Phone 619-532-6666
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