Healthcare Provider Details

I. General information

NPI: 1508360587
Provider Name (Legal Business Name): ZERAHLYNN BALLANCA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 01/01/2026
Certification Date: 01/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20330 N CAVE CREEK RD STE 160
PHOENIX AZ
85024-1280
US

IV. Provider business mailing address

20330 N CAVE CREEK RD STE 160
PHOENIX AZ
85024-1280
US

V. Phone/Fax

Practice location:
  • Phone: 602-786-0000
  • Fax: 602-730-8444
Mailing address:
  • Phone: 602-786-0000
  • Fax: 602-730-8444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number64114
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: