Healthcare Provider Details

I. General information

NPI: 1205091329
Provider Name (Legal Business Name): PARAMESHWARI BALADANDAPANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 11/29/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 TRUXTUN AVE
BAKERSFIELD CA
93301-5008
US

IV. Provider business mailing address

1817 TRUXTUN AVE
BAKERSFIELD CA
93301-5008
US

V. Phone/Fax

Practice location:
  • Phone: 646-470-6611
  • Fax:
Mailing address:
  • Phone: 646-470-6611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberC56171
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number252927
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: