Healthcare Provider Details

I. General information

NPI: 1407445687
Provider Name (Legal Business Name): E ALBERT GUARIN BALBAS MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2021
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E WASHINGTON ST SUITE 300
COLTON CA
92324-8182
US

IV. Provider business mailing address

5 HOLLAND #101
IRVINE CA
92618-2568
US

V. Phone/Fax

Practice location:
  • Phone: 909-824-2422
  • Fax:
Mailing address:
  • Phone: 949-588-2190
  • Fax: 949-588-2199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: EDWARD A BALBAS
Title or Position: PRESIDENT
Credential: MD
Phone: 949-588-2190