MEDICARE: SALMA BALBAS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA59047	CA

General Provider Information

NPI Number	:	1194314104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALMA BALBAS PA-C

Provider Business Mailing Address
First Line	:	28602 JAEGER DR
Second Line	:
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-1320
Country	:	US
Telephone Number	:	949-525-5087
Fax Number	:

Provider Business Practice Location Address
First Line	:	3772 KATELLA AVE STE 206
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-6428
Country	:	US
Telephone Number	:	562-430-4294
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2021
Last Update Date	:	04/18/2023

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