Provider Demographics
NPI:1104919588
Name:BALMACEDA, DANIEL Z (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:Z
Last Name:BALMACEDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 12035
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-0035
Mailing Address - Country:US
Mailing Address - Phone:913-599-3800
Mailing Address - Fax:913-599-3854
Practice Address - Street 1:10550 QUIVIRA RD
Practice Address - Street 2:SUITE 335
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2306
Practice Address - Country:US
Practice Address - Phone:913-599-3800
Practice Address - Fax:913-599-3854
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0428744207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100372270GMedicaid
MO1104919588Medicaid
KS100372270DMedicaid
KSP00825549Medicare PIN
KSY20000008Medicare PIN
KS100372270DMedicaid
A55B435Medicare ID - Type UnspecifiedKANSAS CITY