Healthcare Provider Details

I. General information

NPI: 1316092174
Provider Name (Legal Business Name): SARAH BLYTHE BALLARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EAGLE RD
ALAMEDA CA
94501-5100
US

IV. Provider business mailing address

1 EAGLE RD
ALAMEDA CA
94501-5100
US

V. Phone/Fax

Practice location:
  • Phone: 510-437-3581
  • Fax:
Mailing address:
  • Phone: 510-437-3581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number51412-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number51412-20
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number51412-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: