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General NPI Number Information
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NPI Number | 1063991370
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Entity Type | Individual
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Provider Name | SWETHA BALLI
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Gender | Female
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Dates
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Enumeration Date | 08/08/2018
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 1105 E SPRUCE AVE STE 201
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City | FRESNO
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State | CA
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Zip | 93720-3313
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Country | US
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Telephone | 559-450-2630
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Fax | 559-450-0351
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Provider Business Mailing Address
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Address Line | 1685 E HOME AVE
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City | FRESNO
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State | CA
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Zip | 93728-2027
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Country | US
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Telephone | 559-457-6900
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Fax | 559-400-8432
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A174790
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License Number State | CA
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