MEDICARE: ALGIMANTAS BALCIUNAS MD

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	2085B0100X	Body Imaging Physician	G10603	CA
2	2085N0700X	Neuroradiology Physician	G10603	CA
3	2085N0904X	Nuclear Radiology Physician	G10603	CA
4	2085R0202X	Diagnostic Radiology Physician	G10603	CA
5	2085R0203X	Therapeutic Radiology Physician	G10603	CA
6	2085R0204X	Vascular & Interventional Radiology Physician	G10603	CA
7	2085R0205X	Radiological Physics Physician	G10603	CA
8	2085U0001X	Diagnostic Ultrasound Physician	G10603	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	300040793	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881664050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALGIMANTAS BALCIUNAS MD

Provider Business Mailing Address
First Line	:	PO BOX 707
Second Line	:	BILLING OFFICE, PLACERVILLE RADIOLOGY MEDICAL GROUP
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-0707
Country	:	US
Telephone Number	:	530-626-1166
Fax Number	:	530-626-3826

Provider Business Practice Location Address
First Line	:	1100 MARSHALL WAY
Second Line	:	MARSHALL MEDICAL CENTER
City	:	PLACERVILLE
State	:	CA
Zip	:	95667
Country	:	US
Telephone Number	:	530-622-1441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	09/19/2013

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