Medrano, Mitas Moina Balbin

Medrano, Mitas Moina Balbin is an individual health care provider with primary practice located at 20508 W Daniel Pl , Buckeye AZ 85396-3649. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Medrano, Mitas Moina Balbin can be contacted via phone (650) 580-3503.

Contact Information

Primary practice address
20508 W Daniel Pl Buckeye AZ 85396-3649
Phone: (650) 580-3503
Fax: (623) 776-2813
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 7029 Arizona
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 23719 California

Profile Details

NPI number 1811977457
LBN Legal business name Medrano, Mitas Moina Balbin
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Apr 13th, 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 1811977457 NPPES
Arizona MEDICAID 335861

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