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NPI Code Detail

MEDICARE: GINA M TORRES BALSAMO PA-C

MEDICARE: GINA M TORRES BALSAMO PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA2010-0048NM

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2NMAAA0219OTHERNMMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649587726
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA M TORRES BALSAMO PA-C
Provider Business Mailing Address
First Line : PO BOX 3141
Second Line :
City : CARLSBAD
State : NM
Zip : 88221-3141
Country : US
Telephone Number : 575-725-5552
Fax Number :
Provider Business Practice Location Address
First Line : 259 BLUEBERRY HILL RD
Second Line :
City : EL PRADO
State : NM
Zip : 87529-7305
Country : US
Telephone Number : 575-758-5858
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2010
Last Update Date : 03/10/2026

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