GLENN MARK BALFOUR (NPI# 1104931542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104931542 |
| Entity Type | Individual |
| Full Name | GLENN MARK BALFOUR |
| Credential | M.D. |
| Practice Address |
785 Grand Ave Ste 218 Carlsbad CA 92008-2371 |
| Mailing Address |
5520 Los Robles Dr Carlsbad CA 92008-4424 |
| Practice Telephone | 4425008851 |
| Practice Fax Number | 4425008681 |
| Mailing Telephone | 7608458884 |
| Mailing Fax Number | 4425008681 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2020-04-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2081P0004X |
Physical Medicine & Rehabilitation Specialization: Spinal Cord Injury Medicine |
A86632 | CA | Allopathic & Osteopathic Physicians |
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
A86632 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE PTAN | BF428Z | 01 |
| Street Address |
785 GRAND AVE STE 218 |
| City | CARLSBAD |
| State | CA |
| Zip Code | 92008-2371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760029706 | Todd F Ovokaitys | Internal Medicine | 2260 Rutherford Road, Suite 101, C/o Gematria, Carlsbad, CA 92008 | 2019-12-10 |
| 1710548375 | San Diego Dental Anesthesia | Dentist | 1287 Carlsbad Village Drive, Carlsbad, CA 92008 | 2019-06-25 |
| 1972096717 | Toshiya Kawano | Chiropractor | 5650 El Camino Real Ste 285, Carlsbad, CA 92008 | 2018-06-06 |
| 1184111684 | Brittany Lauren Cheatham | Nurse Practitioner | 345 Walnut Ave, Carlsbad, CA 92008 | 2018-04-19 |
| 1770092843 | Michele Laporte Downey | Counselor | 2910 Jefferson St, Suite 100, Carsbad, CA 92008 | 2017-09-21 |
| 1225567142 | Shana Smith | Occupational Therapy Assistant | 5870 El Camino Real, Carlsbad, CA 92008 | 2017-06-05 |
| 1336690395 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 2559 Camino Real Rd, Carlsbad, CA 92008 | 2016-10-14 |
| 1093174849 | Nhi Thi Diem Nguyen | Pharmacist | 6850 Avenida Encinas, Carlsbad, CA 92008 | 2016-02-22 |
| 1912362112 | Brooke Ann Bellomio | Psychologist | 2558 Roosevelt St. Suite 203, Carlsbad, CA 92008 | 2015-12-15 |
| 1285005660 | Thanh-trinh Doan | Optometrist | 2322 Rutherford Rd., Carlsbad, CA 92008 | 2015-10-12 |
| Find all providers in zip 92008 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023494879 | F Jacob Huff Md | Psychiatry & Neurology | 2244 Masters Road, Carlsbad, CA 92008-3845 | 2015-08-04 |
| 1962798629 | Ellis Raphael Diamond | Psychiatry & Neurology | 3554 Calle Palmito, Carlsbad, CA 92009-8958 | 2011-06-21 |
| 1144540584 | Dona Kim Murphey | Psychiatry & Neurology | 2237 Faraday Ave Ste 120, Carlsbad, CA 92008-7240 | 2010-06-08 |
| 1063420412 | Leonel Perez-limonte | Psychiatry & Neurology | 2324 W Pierce Street, Carlsbad, NM 88220 | 2006-08-03 |
| 1003860537 | North County Neurology Associates Medical Group | Psychiatry & Neurology | 6010 Hidden Valley Rd Ste 200, Carlsbad, CA 92011 | 2006-05-20 |
| 1669859443 | Richard Alexander Lane | Psychiatry & Neurology | 6010 Hidden Valley Rd Ste 200, Carlsbad, CA 92011-4219 | 2015-04-30 |
| 1184011363 | Alise Kathleen Pham | Psychiatry & Neurology | 6010 Hidden Valley Rd Ste 200, Carlsbad, CA 92011-4219 | 2015-04-25 |
| 1851785505 | Arthur K Omuro | Psychiatry & Neurology | 6010 Hidden Valley Rd Ste 200, Carlsbad, CA 92011-4219 | 2015-03-20 |
| 1083015846 | Reshma Gokaldas | Psychiatry & Neurology | 6010 Hidden Valley Rd Ste 200, Carlsbad, CA 92011-4219 | 2014-09-11 |
| 1619288172 | Tara Ann Quesnell | Psychiatry & Neurology | 6010 Hidden Valley Rd Ste 200, Carlsbad, CA 92011-4219 | 2010-06-29 |
| Find all providers in CARLSBAD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.