DR. GREGORY MICHAEL BALOURDAS (NPI# 1194856427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1194856427 |
Entity Type | Individual |
Full Name | DR. GREGORY MICHAEL BALOURDAS |
Credential | M.D. |
Practice Address |
4101 Randolph St San Diego CA 92103-1342 |
Practice Telephone | 6192912430 |
Practice Fax Number | 6192914048 |
Mailing Telephone | 6192912430 |
Mailing Fax Number | 6192914048 |
Enumeration Date | 2007-03-08 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
G51351 | CA | Allopathic & Osteopathic Physicians |
Street Address |
4101 RANDOLPH ST |
City | SAN DIEGO |
State | CA |
Zip Code | 92103-1342 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518206507 | Gregory M. Balourdas, M.d., Inc. | Orthopaedic Surgery | 4101 Randolph St, San Diego, CA 92103-1342 | 2013-02-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
Find all providers in zip 92103 |
Taxonomy Code | 207XS0106X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
Specialization | Hand Surgery |
An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932547536 | Hassan Jon Azimi | Orthopaedic Surgery | 8008 Frost St Ste 403, San Diego, CA 92123-4209 | 2013-06-06 |
1518589357 | Hassan J Azimi Md Inc | Orthopaedic Surgery | 8008 Frost St Ste 403, San Diego, CA 92123-4209 | 2020-05-14 |
1528444171 | Lindsey Urband Md Corp | Orthopaedic Surgery | 8008 Frost St, Suite 403, San Diego, CA 92123-4205 | 2015-08-05 |
1518206507 | Gregory M. Balourdas, M.d., Inc. | Orthopaedic Surgery | 4101 Randolph St, San Diego, CA 92103-1342 | 2013-02-11 |
1912235482 | Samantha Lee Piper | Orthopaedic Surgery | 5893 Copley Dr, Kaiser Permanente Garfield Specialty Center, San Diego, CA 92111-7906 | 2009-11-22 |
1740422997 | Lindsey Starr Urband | Orthopaedic Surgery | 8008 Frost St, Suite 403, San Diego, CA 92123-4205 | 2009-04-02 |
1669547857 | Leo T Kroonen | Orthopaedic Surgery | 34800 Bob Wilson Dr, Nmcsd, San Diego, CA 92134-1098 | 2006-11-22 |
1225130677 | Regents of The University of California-ucsd Medical Group | Orthopaedic Surgery | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2006-09-05 |
1548371925 | Byron King | Orthopaedic Surgery | 3939 Ruffin Rd Ste 101, San Diego, CA 92123-1815 | 2006-08-31 |
1720050321 | Brian Fitzgerald | Orthopaedic Surgery | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2006-02-07 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.