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General NPI Number Information
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NPI Number | 1114399953
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Entity Type | Individual
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Provider Name | HARKIRAT BAL FNP-C
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Gender | Male
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 12/05/2016
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Provider Practice Location Address
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Address Line | 1791 E FIR AVE
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City | FRESNO
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State | CA
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Zip | 93720-3840
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Country | US
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Telephone | 559-326-1222
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Fax | 559-326-1230
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Provider Business Mailing Address
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Address Line | 3001 DOUGLAS BLVD STE 325
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City | ROSEVILLE
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State | CA
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Zip | 95661-4289
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Country | US
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Telephone | 559-326-1222
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Fax | 559-326-1230
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95003003
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License Number State | CA
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