Balboa Ambulance Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

115347 Issued in CA

Legal business name

BALBOA AMBULANCE INC.

Practice address

3550 Afton Rd
San Diego, CA 92123-2184

Phone

(858) 637-3524

Fax

(858) 284-9848

NPI assigned

Aug 5, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John Olson

Title

Administrator

Phone

(619) 440-9386

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1871502146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34577",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921634577",
            "telephone_number": "858-637-3521",
            "fax_number": "858-284-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 AFTON RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232184",
            "telephone_number": "858-637-3524",
            "fax_number": "858-284-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALBOA AMBULANCE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "619-440-9386",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "CA",
            "license": "115347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTE00734F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAN DIEGO EMS PERMIT",
            "identifier": "05-102",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHP LICENSE",
            "identifier": "115347",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jorddy Balandran
• Lydia Balaoing
• Alyssa Lauren Balasco, LCSW
• Maggie Mae Cabral Balat, RN
• Lilit Balayan, DMD
• Balboa Family Dentistry
• Balboa Healthcare, Inc.
• Balboa Hospital
• Balboa Nephrology Associates
• Balboa Nephrology Medical Group, Inc.

• Land Ambulance in San Diego, CA
• Providers in San Diego, CA by specialty
• Land Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.