Balderrama Medical Clinic
Internal Medicine in Van Nuys, CA. Organization (NPI-2).
NPI number1841583424
StatusActive
Last updated in NPPESMay 16, 2011
Details
- NPI
- 1841583424
- Entity type
- Organization (NPI-2)
- Legal business name
- Balderrama Medical Clinic
- Organization subpart
- No
- Enumeration date
- May 16, 2011
- Last updated
- May 16, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
14342 Victory BlvdVan Nuys, CA 91401-1944
Phone 818-908-8000
Mailing address
14342 Victory BlvdVan Nuys, CA 91401-1944
Phone 818-908-8000
Authorized official
Erick R. Balderrama
Physician
8189088000
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