Balboa Surgical Associates Inc.
NPI 1205599149ActiveOrganization· Surgery, Vascular Surgery· Fullerton, CA
Surgery, Vascular Surgery in Fullerton, California, registered in NPPES in October 2021. The authorized official on file is Diana Hart, Billing Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1205599149 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 18, 2021 |
| Last updated in NPPES | Oct 18, 2021 |
| Certified by provider | Oct 18, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery, Vascular Surgery Primary | 2086S0129X | — | — |
| Internal Medicine, Cardiovascular Disease | 207RC0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
Other Surgery, Vascular Surgery providers in Fullerton
- 1538288311