Ballentine, Renee Heather

Ballentine, Renee Heather is an individual health care provider with primary practice located at 1451 Irvine Blvd , Tustin CA 92780-3804. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Ballentine, Renee Heather can be contacted via phone (714) 838-8878.

Contact Information

Primary practice address
1451 Irvine Blvd Tustin CA 92780-3804
Phone: (714) 838-8878
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 20A8509 California

Profile Details

NPI number 1043387046
LBN Legal business name Ballentine, Renee Heather
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated Mar 8th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043387046 NPPES
California MEDICAID 00AX85090

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