| Balaji Medical Corporation | |
|
1406 Park St 100 Alameda CA 94501-4558 | |
| (510) 865-6000 | |
| (510) 865-6066 |
| Full Name | Balaji Medical Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 1406 Park St, Alameda, California |
| Authorized Official Name and Position | Ushakiran Khade (CEO) |
| Authorized Official Contact | 5108656000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Balaji Medical Corporation 1803 Moreland Dr Alameda CA 94501-1643 Ph: (510) 220-3294 | Balaji Medical Corporation 1406 Park St 100 Alameda CA 94501-4558 Ph: (510) 865-6000 |
| NPI Number | 1619173929 |
|---|---|
| Provider Enumeration Date | 06/23/2007 |
| Last Update Date | 12/24/2020 |
| Medicare PECOS PAC ID | 3577647247 |
|---|---|
| Medicare Enrollment ID | O20080220000322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619173929 | NPI | - | NPPES |
| 1466135 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A51012 (California) | Primary |
| Provider Name | Ushakiran Khade |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1699884437 PECOS PAC ID: 2567546237 Enrollment ID: I20080220000337 |
| Provider Name | John Khade |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1952668063 PECOS PAC ID: 0547547853 Enrollment ID: I20201118002353 |
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