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General NPI Number Information
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NPI Number | 1205115128
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Entity Type | Organization
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Legal Business Name | JAIKRISHNA BALKISSON,MD & LAURIE E. SCHWEITZER, MD
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 08/17/2011
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Provider Practice Location Address
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Address Line | 2999 REGENT ST 300
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City | BERKELEY
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State | CA
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Zip | 94705-2190
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Country | US
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Telephone | 510-548-1717
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Fax |
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Provider Business Mailing Address
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Address Line | 2999 REGENT STREET 300
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City | BERKELEY
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State | CA
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Zip | 94705
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Country | US
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Telephone | 510-548-1717
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MISS ANGELIE P. DURANO
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Credential | NP
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Telephone | 510-548-1717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G713950
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G713630
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License Number State | CA
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