Provider Demographics
NPI:1730593666
Name:BALAN, JULIE MALHOTRA (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MALHOTRA
Last Name:BALAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MAY THU
Other - Middle Name:
Other - Last Name:LWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11420 WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-2529
Mailing Address - Country:US
Mailing Address - Phone:714-549-1300
Mailing Address - Fax:714-665-4606
Practice Address - Street 1:11420 WARNER AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-2529
Practice Address - Country:US
Practice Address - Phone:714-549-1300
Practice Address - Fax:714-665-4606
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA145253207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine