Provider Demographics
NPI:1871661660
Name:BALKE, CLARENCE WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARENCE
Middle Name:WILLIAM
Last Name:BALKE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:185 BERRY ST
Mailing Address - Street 2:CAMPUS BOX 0558, LOBBY 3, SUITE 5300
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-5705
Mailing Address - Country:US
Mailing Address - Phone:415-244-1570
Mailing Address - Fax:415-514-8520
Practice Address - Street 1:185 BERRY ST
Practice Address - Street 2:CAMPUS BOX 0558, LOBBY 3, SUITE 5300
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-5705
Practice Address - Country:US
Practice Address - Phone:415-244-1570
Practice Address - Fax:415-514-8520
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2014-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY39765207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYD72282Medicare UPIN