Balboa Therapy Center

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

BALBOA THERAPY CENTER

Practice address

3969 4TH Ave Ste 208
San Diego, CA 92103-3165

Phone

(619) 294-7300

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Sri Gopal

Title

Ceo

Phone

(619) 294-7300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366547176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3969 4TH AVE STE 208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033165",
            "telephone_number": "619-294-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3969 4TH AVE STE 208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033165",
            "telephone_number": "619-294-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALBOA THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOPAL",
        "authorized_official_first_name": "SRI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-294-7300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Balboa Nephrology Associates
• Balboa Nephrology Medical Group, Inc.
• Balboa Nephrology Medical Group,Inc.
• Balboa Park Internal Medicine, Medical Associates Inc
• Balboa Surgical Institute, Inc.
• Balboa Therapy Group, Inc.
• Kristin Balboa, OTR/L
• Alanna Brooke Balboni, MD
• Joseph Balbuena
• Leonor Balcazar

• Comprehensive Outpatient Rehabilitation Facility (CORF) in San Diego, CA
• Providers in San Diego, CA by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.