Provider Demographics
NPI:1902127525
Name:BALCH, KARL RUSSELL (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:RUSSELL
Last Name:BALCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 BAHAMAS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0747
Mailing Address - Country:US
Mailing Address - Phone:213-200-1176
Mailing Address - Fax:
Practice Address - Street 1:2400 BAHAMAS DR STE 200
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0747
Practice Address - Country:US
Practice Address - Phone:661-328-5565
Practice Address - Fax:661-328-5573
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNONE207X00000X
VA0116029604390200000X
CAA149214207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program