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NPI Code Detail

MEDICARE: DR. ANUPAMA BALAJI M.D.

MEDICARE: DR. ANUPAMA BALAJI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician31451AZ

General Provider Information

NPI Number : 1083899322
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANUPAMA BALAJI M.D.
Provider Business Mailing Address
First Line : 3800 DALE ROAD
Second Line :
City : MODESTO
State : CA
Zip : 95355
Country : US
Telephone Number : 209-557-1650
Fax Number :
Provider Business Practice Location Address
First Line : 3250 W LOWER BUCKEYE RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85009-6729
Country : US
Telephone Number : 602-506-2906
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2008
Last Update Date : 11/21/2016

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