Provider Demographics
NPI:1689495681
Name:BALAROSAN, RUTH (NURSE)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:BALAROSAN
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9730 WILSHIRE BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2004
Mailing Address - Country:US
Mailing Address - Phone:310-634-4508
Mailing Address - Fax:
Practice Address - Street 1:9730 WILSHIRE BLVD STE 207
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2004
Practice Address - Country:US
Practice Address - Phone:310-634-4508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA691856251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion