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NPI Code Detail

MEDICARE: DR. BILL BALNTAS

MEDICARE: DR. BILL BALNTAS
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
1183500000XPharmacist61585CA

General Provider Information

NPI Number : 1750736674
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BILL BALNTAS
Provider Business Mailing Address
First Line : 1609 EL RITO AVE
Second Line :
City : GLENDALE
State : CA
Zip : 91208-2032
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1701 S WESTERN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90006-5803
Country : US
Telephone Number : 323-731-9247
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2016
Last Update Date : 04/28/2016

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Directions to “ DR. BILL BALNTAS ” Practice Location

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