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General NPI Number Information
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NPI Number | 1144273533
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Entity Type | Individual
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Provider Name | DALJIT S BAL MD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 14155 N 83RD AVE STE 122
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City | PEORIA
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State | AZ
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Zip | 85381-5639
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Country | US
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Telephone | 623-773-1161
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Fax | 623-773-1181
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Provider Business Mailing Address
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Address Line | 6501 W DAILEY ST
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City | GLENDALE
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State | AZ
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Zip | 85306-3770
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Country | US
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Telephone | 623-773-1161
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Fax | 623-773-1181
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 27357
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License Number State | AZ
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