MARYAM BALOUCH M.D. NPI 1215201108

NPI Information

NPI: 1215201108
Provider Name: MARYAM BALOUCH, M.D.
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

Organization: SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP

PECOS Registration: Yes

Address:
1955 CITRACADO PKWY
SUITE 300
ESCONDIDO, CA
ZIP 92029
Phone: (760) 743-0546
Get Directions

Maryam Balouch, M.D. is a cardiovascular disease internal medicine in Escondido, CA with 13 years of experience. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Maryam Balouch, M.D. NPI is 1215201108. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduation Year:2011

The provider's business location address is:

1955 CITRACADO PKWY
SUITE 300
ESCONDIDO, CA
ZIP 92029-110
Phone: (760) 743-0546
Fax: (760) 743-8837

The NPI 1215201108 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/24/2012 and was last updated on 12/8/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	207RC0000X	Internal Medicine	Cardiovascular Disease	A121988	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	113998	OTHER	CALIFORNIA	SID # 113998

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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