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Rowena B Baltazar

Dentist

Dental Providers

180 Skyline Plz, Daly City, CA 94015-3823

PECOS Enrollment

This provider is enrolled in PECOS as ROWENA BALTAZAR.

Based on the most recent information from CMS, provider Rowena B Baltazar is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1376754614
Provider Type
Individual
Full Name
Baltazar, Rowena B
Title
Dr.

Gender
Female
Sole Proprietor
No
Enumeration Date
5/25/2007
Last Updated
7/8/2007

Contact Information

Practice Location

180 Skyline Plz, Daly City, CA 94015-3823

(650) 994-3471

Unlisted Fax

Mailing Location

180 Skyline Plz, Daly City, CA 94015-3823

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1223G0001X Primary	Description Dentist Dental Providers	License 40531 California

Rowena B Baltazar

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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Jun, Bo

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Johnston, Michael Warren

Yee, John C. D.

Nakamoto, Douglas Kiyoshi

Cheng, Phuong H

Espina, Eilene Jimenez

Soliman, Joseph Youhanna