Provider Demographics
NPI:1326146705
Name:BALYTSKY, NATALIA (MD)
Entity Type:Individual
Prefix:DR
First Name:NATALIA
Middle Name:
Last Name:BALYTSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:98 MONTGOMERY DR
Mailing Address - Street 2:STE.C
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-6615
Mailing Address - Country:US
Mailing Address - Phone:707-591-0619
Mailing Address - Fax:707-591-0617
Practice Address - Street 1:98 MONTGOMERY DR
Practice Address - Street 2:STE.C
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-6615
Practice Address - Country:US
Practice Address - Phone:707-591-0619
Practice Address - Fax:707-591-0617
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA83273207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI23929Medicare UPIN