# DERMDOCS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Portrait Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972230217
- **Authorized official:** MR. PATRICK BLAKE MD (CHIEF MEDICAL OFFICER)
- **Authorized official phone:** (858) 375-3653

## Contact information

- **Practice address:** 1022 N EL CAMINO REAL \# 134, ENCINITAS, CA 92024-1320
- **Practice address phone:** (858) 293-1152
- **Practice address fax:** (858) 780-5287
- **Mailing address:** 12707 HIGH BLUFF DR STE 350, SAN DIEGO, CA 92130-3003
- **Mailing address phone:** (858) 293-1152

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 08/05/2022
- **Last updated:** 08/18/2022