Balboa Surgical Associates Inc.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

BALBOA SURGICAL ASSOCIATES INC.

Practice address

2501 E Chapman Ave Ste 220
Fullerton, CA 92831-3108

Phone

(949) 872-5192

NPI assigned

Oct 18, 2021

Organization subpart

No

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

Authorized official

Name

Diana Hart

Title

Billing Manager

Phone

(949) 872-5192

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Quang T. Vo, M.D.

  • Surgery Physician
  • Monterey Park, CA
  • NPI 1821107749
  Medicare reassignment NPD

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1205599149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 LESSAY",
            "city": "NEWPORT COAST",
            "state": "CA",
            "postal_code": "926571043",
            "telephone_number": "949-872-5192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E CHAPMAN AVE STE 220",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313108",
            "telephone_number": "949-872-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALBOA SURGICAL ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "949-872-5192"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mojdeh Bakhshi Hassan Zadeh
• Balance Acupuncture, Inc.
• Rosemarie Devio Balandra Raif, CNS
• Kevin Vallabh Balar, M.D.
• Mary Jacaquelyn Coloma Balba, MPT
• Maria Luz Balcarse
• Cristina Valenciana Balderrama
• Elaine Baldueza, RN, BSN
• Ballenger and Associates, Inc.
• Cathy Louise Ballenger, LMFT

• Vascular Surgery Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.