Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | C28932 | CA |
NPI | 1003887027 |
---|---|
Provider Name | Dr. Steven A Balch |
First Address | San Diego, CA 92123 |
Second Address | Encinitas, CA 92024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2006 |
Last Update Date | 01/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A33787 | (02) | |
C28932 | MD LICENSE (01) | CA |