# PETER BALES, M.D., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457400558
- **Authorized official:** DR. PETER BALES M.D. (OWNER)
- **Authorized official phone:** (916) 788-8201

## Contact information

- **Practice address:** 1613 EUREKA RD, SUITE 100, ROSEVILLE, CA 95661-3029
- **Practice address phone:** (916) 788-8201
- **Practice address fax:** (916) 788-8205
- **Mailing address:** PO BOX 44, LOOMIS, CA 95650-0044
- **Mailing address phone:** (916) 788-8201
- **Mailing address fax:** (916) 788-8205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | G63997 | CA | Yes |

## Other

- **Enumeration date:** 01/09/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00G639970 | — | CA |
| 01 | — | 1669568994 | INDIVIDUAL PROVIDER NPI | CA |