Gregory M. Balourdas, M.D., Inc.

Primary specialty

Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X

License

G51351 Issued in CA

Legal business name

GREGORY M. BALOURDAS, M.D., INC.

Practice address

4101 Randolph St
San Diego, CA 92103-1342

Phone

(619) 291-2430

Fax

(619) 291-4048

NPI assigned

Feb 11, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Gregory M Balourdas, M.D.

Title

President

Phone

(619) 291-2430

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1360540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360540800000",
    "number": "1518206507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 RANDOLPH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031342",
            "telephone_number": "619-291-2430",
            "fax_number": "619-291-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 RANDOLPH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031342",
            "telephone_number": "619-291-2430",
            "fax_number": "619-291-4048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY M. BALOURDAS, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-11",
        "last_updated": "2013-02-11",
        "status": "A",
        "authorized_official_last_name": "BALOURDAS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-291-2430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "CA",
            "license": "G51351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Hand Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Orthopaedic Hand Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.