| Doctor Name: | DOUGLAS GERALD BALLAINE |
| NPI Number: | 1487653192 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 20A6840 |
| Business Practice Address: | 549 Peppertree Dr Windsor, CA - 954928362 |
| Business Phone Number: | 7078375062 |
| Business Fax Number: | 7078375624 |
| Mailing Address: | 549 Peppertree Dr, WINDSOR |
| State: | CA |
| Postal Code: | 954928362 |
| Phone Number: | 7078375062 |
| Fax Number: | 7078375624 |
| NPI Enumeration Date: | 07/15/2005 |
| NPI Last Update Date: | 12/10/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 20A6840 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |