Provider Demographics
NPI:1609139591
Name:BALFOUR, STEPHEN AARON (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:AARON
Last Name:BALFOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6191 N THESTA ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5266
Mailing Address - Country:US
Mailing Address - Phone:209-663-9446
Mailing Address - Fax:
Practice Address - Street 1:6191 N THESTA ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5266
Practice Address - Country:US
Practice Address - Phone:209-663-9446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1560142085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology