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Organization
SKYLINE UROLOGY
Active
Organization
SKYLINE UROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN BLASINGAME BSN, RN (DISPENSARY MANAGER)
(858) 888-7700
Entity
Organization
Contact information
Practice address
23456 HAWTHORNE BLVD, BUILDING 5, SUITE 260, TORRANCE, CA 90505
(310) 602-5005
(310) 373-7895
Mailing address
23456 HAWTHORNE BLVD, STE 260, BUILDING #5, TORRANCE, CA 90505-6658
(310) 602-5005
(310) 373-7895
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
FNP38252
CA
Other
Enumeration date
05/27/2006
Last updated
09/20/2021
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