Balbas Integrated Medical Group, Inc.

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

A83354 Issued in CA

Legal business name

BALBAS INTEGRATED MEDICAL GROUP, INC.

Practice address

1618 Sullivan Ave
208
Daly City, CA 94015-1967

Phone

(707) 824-4203

NPI assigned

Jan 15, 2014

Last updated

Jan 15, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Angelita G. Balbas, M.D.

Title

President

Phone

(707) 824-4203

Specialties & licenses 1

Addresses

Other names 1

• Coastside Medical Other name

Locations

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1629490297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 SULLIVAN AVE",
            "address_2": "525",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940151967",
            "telephone_number": "707-824-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 SULLIVAN AVE",
            "address_2": "208",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940151967",
            "telephone_number": "707-824-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALBAS INTEGRATED MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "BALBAS",
        "authorized_official_first_name": "ANGELITA",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-824-4203",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "A83354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastside Medical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mya Bagley
• Ellen Bahr, DPT
• Harminder Bajaj, RPH
• Evelyn F Balancio, LCSW
• Matthew Balantac, BA
• Alex A Balekian, M.D.
• Stephanie Balon Wong
• Kylle Micael Baloran
• Rowena B Baltazar
• Erica Bandrup

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Daly City, CA
• Providers in Daly City, CA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.