Individual
MRS. AMARAVATHI BALAKRISHNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
155 N JACKSON AVE STE 101, SUITE 101, SAN JOSE, CA 95116-1925
(408) 259-1250
(408) 259-7439
Mailing address
155 N JACKSON AVE STE 101, SAN JOSE, CA 95116-1925
(408) 259-1250
(408) 259-7439
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A30274
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A302740
—
CA
Enumeration date
07/06/2006
Last updated
12/20/2011
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