MEDICARE: GOVINDAN BALASUBRAMANIAN MD INC

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
1	207L00000X	Anesthesiology Physician	A39680	CA

General Provider Information

NPI Number	:	1285819391
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOVINDAN BALASUBRAMANIAN MD INC

Provider Business Mailing Address
First Line	:	PO BOX 2029
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93303-2029
Country	:	US
Telephone Number	:	661-335-7755
Fax Number	:	661-335-7766

Provider Business Practice Location Address
First Line	:	9300 STOCKDALE HWY STE 200
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93311-3611
Country	:	US
Telephone Number	:	661-663-3700
Fax Number	:	661-663-3737

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. SANDY REED
Credential	:
Telephone Number	:	661-335-7755

Provider Enumeration Date	:	01/08/2008
Last Update Date	:	09/23/2010

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