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Individual

KENT ALAN BLADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-6702
(619) 532-7272
Mailing address
5979 SEACREST VIEW RD, SAN DIEGO, CA 92121-4355
(619) 532-6702
(619) 532-7272

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD 417456
PA

Other

Enumeration date
05/04/2006
Last updated
07/08/2007
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