Samuel C Ballon MD Facog Facs Frcsc a Prof Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

G21751 Issued in CA

Legal business name

SAMUEL C BALLON MD FACOG FACS FRCSC A PROF CORPORATION

Practice address

2504 Samaritan Dr Ste 20
San Jose, CA 95124-4005

Phone

(408) 356-3725

Fax

(408) 376-3713

NPI assigned

Jan 10, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Samuel C Ballon, M.D.

Title

Ceo

Phone

(408) 356-3725

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431388800000",
    "number": "1205012127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 SAMARITAN DR STE 20",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244005",
            "telephone_number": "408-356-3725",
            "fax_number": "408-376-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 SAMARITAN DR STE 20",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244005",
            "telephone_number": "408-356-3725",
            "fax_number": "408-376-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL C BALLON MD FACOG FACS FRCSC A PROF CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2015-05-12",
        "status": "A",
        "authorized_official_last_name": "BALLON",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-356-3725",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G21751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcus Stewart Sampson
• Simrendeep Kaur Samra
• Avy Linda Samreth
• Lars Samson
• Quentin Samuda
• Ashourina Samuel, MFT
• Christina Maher Samuel, NP-RN
• Kaycee Kealoha Lokelani San Agustin-Nordmeier, PHARMD
• Stefanni San Agustin
• Rachael Anne San Filippo

• Specialist in San Jose, CA
• Providers in San Jose, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.