Provider Demographics
NPI:1609935287
Name:BALICA, MIHAELA R (MD)
Entity type:Individual
Prefix:
First Name:MIHAELA
Middle Name:R
Last Name:BALICA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 DE SOTO AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6701
Mailing Address - Country:US
Mailing Address - Phone:818-719-2000
Mailing Address - Fax:
Practice Address - Street 1:881 ALMA REAL DR STE 101
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3792
Practice Address - Country:US
Practice Address - Phone:310-829-8923
Practice Address - Fax:424-212-5936
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63010207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine