Individual
BALU GADHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11306 MOUNTAIN VIEW AVE STE C, LOMA LINDA, CA 92354-3832
(909) 255-0108
(909) 966-4529
Mailing address
11306 MOUNTAIN VIEW AVE STE C, LOMA LINDA, CA 92354-3832
(909) 255-0108
(909) 966-4529
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A50258
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A502580
BLUE SHIELD ID #
—
05
—
00A502580
—
CA
01
—
045266
HEALTH NET ID #
—
01
—
10178522
RAILROAD
—
01
—
110080893
RAILROAD
—
Enumeration date
05/18/2006
Last updated
03/19/2024
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