Healthcare Provider Details

I. General information

NPI: 1346541554
Provider Name (Legal Business Name): RACHNA BALI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2010
Last Update Date: 12/15/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20103 LAKE CHABOT RD HOSPITALIST OFFICE
CASTRO VALLEY CA
94546-5305
US

IV. Provider business mailing address

20103 LAKE CHABOT RD HOSPITALIST OFFICE
CASTRO VALLEY CA
94546-5305
US

V. Phone/Fax

Practice location:
  • Phone: 510-889-5082
  • Fax: 510-733-0878
Mailing address:
  • Phone: 510-889-5082
  • Fax: 510-733-0878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number20A11595
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: