Provider Demographics
NPI:1306828868
Name:BALUYOT, EUNICE M (MD)
Entity Type:Individual
Prefix:DR
First Name:EUNICE
Middle Name:M
Last Name:BALUYOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 W CHILDS AVE
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341-6805
Mailing Address - Country:US
Mailing Address - Phone:209-383-1848
Mailing Address - Fax:209-384-3966
Practice Address - Street 1:1510 FLORIDA AVE
Practice Address - Street 2:H
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4437
Practice Address - Country:US
Practice Address - Phone:209-574-1030
Practice Address - Fax:209-574-1038
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54525207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A545250OtherBLUE SHIELD OF CA PIN
CA00A545250Medicaid
CA087727OtherBOARD CERT #
CABB5080166OtherDEA CERT #
CA00A545250OtherBLUE SHIELD OF CA PIN
CA087727OtherBOARD CERT #