Healthcare Provider Details

I. General information

NPI: 1366478414
Provider Name (Legal Business Name): KRYSTYNA T BELSKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 03/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 W H ST SUITE # 330
OAKDALE CA
95361-3588
US

IV. Provider business mailing address

1425 W H ST SUITE # 330
OAKDALE CA
95361-3588
US

V. Phone/Fax

Practice location:
  • Phone: 209-848-8133
  • Fax: 209-845-2134
Mailing address:
  • Phone: 209-848-8133
  • Fax: 209-845-2134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA45854
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: