MEDICARE: LEIGH ANN BALLOU 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
1	363AS0400X	Surgical Physician Assistant	PA16765	CA

General Provider Information

NPI Number	:	1891794657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEIGH ANN BALLOU PA-C

Provider Business Mailing Address
First Line	:	25455 BARTON RD
Second Line	:	SUITE 108-A
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-3128
Country	:	US
Telephone Number	:	909-558-6386
Fax Number	:	909-558-6206

Provider Business Practice Location Address
First Line	:	11234 ANDERSON ST
Second Line	:	RM 2562B
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-2804
Country	:	US
Telephone Number	:	909-558-6386
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1629773288 — AMANDA QUYNH PHAN
Practice Location Address:

11234 ANDERSON ST
LOMA LINDA, CA
92354-2804

Practice Phone: 909-558-4174
Practice Fax:

1730354929 — DR. JOSEPH INSUNG KANG JR. M.D., PH.D.
Practice Location Address:

11234 ANDERSON ST , ROOM B121
LOMA LINDA, CA
92354-2804

Practice Phone: 909-552-8056
Practice Fax: 909-552-4829

1881145852 — KIMBERLY MARIE GRIFFIN AGACNP-BC
Practice Location Address:

11234 ANDERSON ST
LOMA LINDA, CA
92354-2804

Practice Phone: 909-558-4475
Practice Fax:

1689310401 — PEILIN GE MD
Practice Location Address:

11234 ANDERSON ST
LOMA LINDA, CA
92354-2804

Practice Phone: 909-558-4015
Practice Fax:

1730172693 — DR. TOMMY YOUNGHO KIM M.D.
Practice Location Address:

11234 ANDERSON ST , A 108
LOMA LINDA, CA
92354-2804

Practice Phone: 909-558-4000
Practice Fax:

1639160070 — DR. JOSEPH SOO M.D.
Practice Location Address:

11234 ANDERSON ST , ROOM 2532
LOMA LINDA, CA
92354-2804

Practice Phone: 619-592-3235
Practice Fax:

Directions to “ LEIGH ANN BALLOU PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.