Active NPI
Connie CHI Balen, RPH.
- Pharmacist
- San Diego, CA
National Provider Identifier
1063690519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 45999
- Practice address
- 11939 Rancho Bernardo Rd
San Diego, CA 92128-2073 - Phone
- (858) 674-2365
- NPI assigned
- Feb 7, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 45999 | CA | Primary |
Addresses
Primary practice location
11939 Rancho Bernardo Rd
San Diego, CA 92128-2073
Mailing address
15079 Levita CT
Poway, CA 92064-2432
Phone (858) 748-7804
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45999 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202342400000",
"number": "1063690519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15079 LEVITA CT",
"city": "POWAY",
"state": "CA",
"postal_code": "920642432",
"telephone_number": "858-748-7804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11939 RANCHO BERNARDO RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921282073",
"telephone_number": "858-674-2365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALEN",
"first_name": "CONNIE",
"middle_name": "CHI",
"name_prefix": "Mrs.",
"credential": "RPH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-07",
"last_updated": "2008-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "45999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.