Provider Demographics
NPI:1023184876
Name:BALIAN, MARSHA (RNNP)
Entity Type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:
Last Name:BALIAN
Suffix:
Gender:F
Credentials:RNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 W MACARTHUR BLVD
Mailing Address - Street 2:KAISER PERMANENTE
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5642
Mailing Address - Country:US
Mailing Address - Phone:510-752-7475
Mailing Address - Fax:
Practice Address - Street 1:201 WEST MACARTHUR BLVD
Practice Address - Street 2:KAISER PERMANANTE
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-1504
Practice Address - Country:US
Practice Address - Phone:510-752-7475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA321340363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP73643ZZZ24707ZMedicare UPIN