=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437370046
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CRAIG JAMES BALL M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 73710 ALESSANDRO DR.
-----------------------------------------------------
City | PALM DESERT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92260
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-837-0364
-----------------------------------------------------
Fax | 760-340-1601
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 73710 ALESSANDRO DR.
-----------------------------------------------------
City | PALM DESERT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92260
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-837-0364
-----------------------------------------------------
Fax | 760-340-1601
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | G38467
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------