Provider Demographics
NPI:1871880716
Name:LABALO, VLADIMIR (MD)
Entity type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:
Last Name:LABALO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2841 LOMITA BLVD
Mailing Address - Street 2:STE. 135
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5116
Mailing Address - Country:US
Mailing Address - Phone:310-784-6954
Mailing Address - Fax:310-326-5679
Practice Address - Street 1:2841 LOMITA BLVD
Practice Address - Street 2:STE. 135
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5116
Practice Address - Country:US
Practice Address - Phone:310-784-6954
Practice Address - Fax:310-326-5679
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301097987207R00000X
CAA141164207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine