Basic Information
| Provider Information | |||||||||
| NPI: | 1942498928 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BALAGTAS | ||||||||
| FirstName: | JAY MICHAEL | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 WELCH RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943041811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507235535 | ||||||||
| FaxNumber: | 6507235231 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 WELCH RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943041811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507235535 | ||||||||
| FaxNumber: | 6507235231 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2007 | ||||||||
| LastUpdateDate: | 09/14/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0207X | A93450 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Hematology-Oncology |
No ID Information.