Provider Demographics
NPI:1902075831
Name:BALGAS, DELRAE Y (LM)
Entity Type:Individual
Prefix:
First Name:DELRAE
Middle Name:Y
Last Name:BALGAS
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5265
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92863-5265
Mailing Address - Country:US
Mailing Address - Phone:714-450-0069
Mailing Address - Fax:
Practice Address - Street 1:5031 E ORANGETHORPE AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-1131
Practice Address - Country:US
Practice Address - Phone:714-450-0069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLM 140176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife