Active NPI
Manuel Balikian, MD
- Internal Medicine Physician
- Clovis, CA
National Provider Identifier
1043374465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A30168
- Practice address
- 275 W Herndon Ave
Clovis, CA 93612-0204 - Phone
- (559) 324-6200
- NPI assigned
- Dec 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A30168 | CA | Primary |
Addresses
Primary practice location
275 W Herndon Ave
Clovis, CA 93612-0204
Mailing address
2579 E El Paso Ave
Fresno, CA 93720-0507
Phone (559) 323-9922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A30168 | Other | CA | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A30168 | CA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187740800000",
"number": "1043374465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2579 E EL PASO AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937200507",
"telephone_number": "559-323-9922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 W HERNDON AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936120204",
"telephone_number": "559-324-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALIKIAN",
"first_name": "MANUEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-20",
"last_updated": "2007-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A30168",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "A30168",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.