Rowena B Baltazar

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40531 Issued in CA

Practice address

180 Skyline PLZ
Daly City, CA 94015-3823

Phone

(650) 994-3471

NPI assigned

May 25, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376754614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 SKYLINE PLZ",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940153823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 SKYLINE PLZ",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940153823",
            "telephone_number": "650-994-3471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTAZAR",
        "first_name": "ROWENA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Balantac, BA
• Balbas Integrated Medical Group, Inc.
• Alex A Balekian, M.D.
• Stephanie Balon Wong
• Kylle Micael Baloran
• Erica Bandrup
• Kevin Bang, DDS, MD
• Lien Ngoc Bang
• Zerina Bangawan, FNP
• Jacquelyn Banouvong

• General Practice Dentistry in Daly City, CA
• Providers in Daly City, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.