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NPI Code Detail

MEDICARE: DAVID G BALTER M.D.

MEDICARE: DAVID G BALTER 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
1207N00000XDermatology PhysicianG342698CA

General Provider Information

NPI Number : 1598711376
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID G BALTER M.D.
Provider Business Mailing Address
First Line : 2030 VIBORG RD
Second Line : SUITE 202
City : SOLVANG
State : CA
Zip : 93463-2220
Country : US
Telephone Number : 805-688-4236
Fax Number :
Provider Business Practice Location Address
First Line : 2030 VIBORG RD
Second Line : SUITE 202
City : SOLVANG
State : CA
Zip : 93463-2220
Country : US
Telephone Number : 805-688-4236
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 07/08/2007

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