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General NPI Number Information
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NPI Number | 1326055658
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Entity Type | Individual
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Provider Name | SANGEETHA BALAKRISHNAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 11/12/2018
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Provider Practice Location Address
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Address Line | 2287 MOWRY AVE STE H-I
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City | FREMONT
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State | CA
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Zip | 94538-1622
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Country | US
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Telephone | 510-248-1620
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Fax | 510-739-5740
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Provider Business Mailing Address
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Address Line | 2287 MOWRY AVE STE H-I
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City | FREMONT
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State | CA
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Zip | 94538-1622
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Country | US
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Telephone | 510-248-1620
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Fax | 510-739-5740
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 239934-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A 112505
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | A 112505
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License Number State | CA
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