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General NPI Number Information
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NPI Number | 1215831185
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Entity Type | Organization
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Legal Business Name | BALBOA SURGERY AND CLINICAL RESEARCH
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 13420 NEWPORT AVE STE E
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City | TUSTIN
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State | CA
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Zip | 92780-3745
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Country | US
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Telephone | 714-352-5550
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Fax |
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Provider Business Mailing Address
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Address Line | 21163 NEWPORT COAST DR PO BOX 294
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City | NEWPORT COAST
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State | CA
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Zip | 92657-1123
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BENJAMIN MICHAEL SAVASKY
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Credential | D.P.M.
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Telephone | 248-808-9072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State | NULL
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