Provider Demographics
NPI:1811077704
Name:BALTINS, ALDIS (MD)
Entity type:Individual
Prefix:DR
First Name:ALDIS
Middle Name:
Last Name:BALTINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1252 AIRPORT PARK BLVD
Mailing Address - Street 2:SUITE C7
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-5979
Mailing Address - Country:US
Mailing Address - Phone:707-468-0471
Mailing Address - Fax:707-468-1182
Practice Address - Street 1:1252 AIRPORT PARK BLVD
Practice Address - Street 2:SUITE C7
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5979
Practice Address - Country:US
Practice Address - Phone:707-468-0471
Practice Address - Fax:707-468-1182
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG28762207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G287620Medicaid
CA200008280OtherRAILROAD MEDICARE
CA0801030001Medicare NSC
CA00G287620Medicare ID - Type Unspecified
CA200008280OtherRAILROAD MEDICARE