1740338946 NPI number — HIEU T. BALL, M.D., INC.

Table of content: (NPI 1740338946)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740338946 NPI number — HIEU T. BALL, M.D., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIEU T. BALL, M.D., INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CALIFORNIA COMPREHENSIVE SPINE INSTITUTE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740338946
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 PARK PL
Provider Second Line Business Mailing Address:
SUITE 140
Provider Business Mailing Address City Name:
SAN RAMON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94583-4460
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-838-8830
Provider Business Mailing Address Fax Number:
925-838-8836

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 PARK PL
Provider Second Line Business Practice Location Address:
140
Provider Business Practice Location Address City Name:
SAN RAMON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94583-4460
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-838-8830
Provider Business Practice Location Address Fax Number:
925-838-8836
Provider Enumeration Date:
01/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BALL
Authorized Official First Name:
HIEU
Authorized Official Middle Name:
THANH
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
925-838-8830

Provider Taxonomy Codes

  • Taxonomy code: 207XS0117X , with the licence number:  A72834 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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