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General NPI Number Information
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NPI Number | 1487468021
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Entity Type | Individual
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Provider Name | ANA BALBOA
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Gender | Female
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 1888 W DEL SOL LN
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City | YUMA
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State | AZ
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Zip | 85364-6190
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Country | US
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Telephone | 928-941-4219
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 86537
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City | TUCSON
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State | AZ
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Zip | 85754-6537
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Country | US
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Telephone | 520-721-1887
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Fax | 520-372-7126
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 1561379
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License Number State | AZ
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