Organization
PETER BALES, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER BALES M.D. (OWNER)
(916) 788-8201
Entity
Organization
Contact information
Practice address
1613 EUREKA RD, SUITE 100, ROSEVILLE, CA 95661-3029
(916) 788-8201
(916) 788-8205
Mailing address
PO BOX 44, LOOMIS, CA 95650-0044
(916) 788-8201
(916) 788-8205
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G63997
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G639970
—
CA
01
—
1669568994
INDIVIDUAL PROVIDER NPI
CA
Enumeration date
01/09/2007
Last updated
08/22/2020
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