Balboa Nephrology Medical Group,Inc.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

BALBOA NEPHROLOGY MEDICAL GROUP,INC.

Practice address

790 W Orange Ave
Ste B
El Centro, CA 92243-3274

Phone

(760) 353-0404

Fax

(760) 353-5391

NPI assigned

Jan 28, 2008

Last updated

Jan 16, 2026By 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

Stephanie Wenceslao

Title

Contracts & Credentialing

Phone

(858) 810-8000

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vince Hyun Ha, MD

  • Nephrology Physician
  • Corona, CA
  • NPI 1568587061
  NPD (past)

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768521600000",
    "number": "1790962199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9373 HAZARD WAY STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231226",
            "telephone_number": "858-810-8000",
            "fax_number": "858-268-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 W ORANGE AVE",
            "address_2": "STE B",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922433274",
            "telephone_number": "760-353-0404",
            "fax_number": "760-353-5391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALBOA NEPHROLOGY MEDICAL GROUP,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A",
        "authorized_official_last_name": "WENCESLAO",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CONTRACTS & CREDENTIALING",
        "authorized_official_telephone_number": "858-810-8000"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bahbak Adrangi MD
• Baker and Khorsand Dental Corporation
• Gracie Galindo Baker
• Kris Vaughn Baker
• Balboa Nephrology Med GRP Inc
• Jacqueline Baltazar
• Darren Bandy
• Tania Susana Banuelos
• Victoria Marie Baran, PA
• Andrea Barker

• Nephrology Physician in El Centro, CA
• Providers in El Centro, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; 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.