Provider Demographics
NPI:1932438918
Name:IN BALANCE ACUPUNCTURE
Entity type:Organization
Organization Name:IN BALANCE ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:BARANZINI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:209-879-9764
Mailing Address - Street 1:1770 N TRACY BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-2428
Mailing Address - Country:US
Mailing Address - Phone:209-879-9764
Mailing Address - Fax:866-929-4101
Practice Address - Street 1:1770 N TRACY BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-2428
Practice Address - Country:US
Practice Address - Phone:209-879-9764
Practice Address - Fax:866-929-4101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-21
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11545171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty