Balaji Medical Corporation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A51012 Issued in CA

Legal business name

BALAJI MEDICAL CORPORATION

Practice address

1406 Park St
100
Alameda, CA 94501-4558

Phone

(510) 865-6000

Fax

(510) 865-6066

NPI assigned

Jun 23, 2007

Organization subpart

No

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

Authorized official

Name

Ushakiran KhadeNPI 1699884437

Title

Ceo

Phone

(510) 865-6000

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ushakiran Khade, MD

  • General Practice Physician
  • Alameda, CA
  • NPI 1699884437
  Medicare reassignment NPD Authorized official
• John Khade, M.D.

  • General Practice Physician
  • Alameda, CA
  • NPI 1952668063
  Medicare reassignment NPD

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

{
    "created_epoch": "1182556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608768000000",
    "number": "1619173929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 MORELAND DR",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011643",
            "telephone_number": "510-220-3294",
            "fax_number": "510-865-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 PARK ST",
            "address_2": "100",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014558",
            "telephone_number": "510-865-6000",
            "fax_number": "510-865-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALAJI MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-23",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A",
        "authorized_official_last_name": "KHADE",
        "authorized_official_first_name": "USHAKIRAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-865-6000"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A51012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1466135",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Nishimura Baba, O.D.
• Arthur Martin Baca, M.D., PH.D.
• Hai Ryun Back
• Rene Aytin Bagus, DDS
• Madeline C Bailey, MSW
• Danielle Balanon
• Jason Balaoing
• Victoriya Balashova
• Arielle Melissa Balbus
• Alexandra Balderas Martinez

• Primary Care Clinic/Center in Alameda, CA
• Providers in Alameda, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.