Organization Active NPI

Ambika Bali MD Inc

  • Gastroenterology Physician
  • Anaheim, CA
National Provider Identifier
1831286822
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A051761 Issued in CA
Legal business name
AMBIKA BALI MD INC
Practice address
1211 W la Palma Ave Ste 409
Anaheim, CA 92801-2806
Phone
(714) 999-0909
Fax
(714) 999-0906
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Authorized official

Name
Dr. Ambika Bali, M.D.NPI 1427096478
Title
President
Phone
(714) 999-0909

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X A051761 CA Primary

Addresses

Primary practice location

1211 W la Palma Ave Ste 409
Anaheim, CA 92801-2806

Mailing address

PO Box 5216
Buena Park, CA 90622-5216
Phone (714) 999-0909

Other identifiers 1

IdentifierTypeStateIssuer
00A517610MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100915000460 CA Part B Supplier - Clinic/Group Practice 1456476399 Receives reassigned benefits from 1 practitioner
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory

Locations

1211 W La Palma Ave
Ste 409
Anaheim, CA 92801
Phone (714) 879-6009

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423094400000",
    "number": "1831286822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5216",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906225216",
            "telephone_number": "714-999-0909",
            "fax_number": "714-999-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE STE 409",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012806",
            "telephone_number": "714-999-0909",
            "fax_number": "714-999-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBIKA BALI MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2015-02-05",
        "status": "A",
        "authorized_official_last_name": "BALI",
        "authorized_official_first_name": "AMBIKA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-999-0909",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A051761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A517610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.