Provider Demographics
NPI:1932691805
Name:BALE, DONALD WILLIAM
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:WILLIAM
Last Name:BALE
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:DONALD
Other - Middle Name:WILLIAM
Other - Last Name:BALE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLEEP MANAGEMENT SER
Mailing Address - Street 1:1652 W TEXAS ST STE 223
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6067
Mailing Address - Country:US
Mailing Address - Phone:415-308-1996
Mailing Address - Fax:888-250-8919
Practice Address - Street 1:1652 W TEXAS ST STE 223
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6067
Practice Address - Country:US
Practice Address - Phone:415-308-1996
Practice Address - Fax:888-250-8919
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic