Individual
BETH W BLACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5200 IRVINE BLVD SPC 339, IRVINE, CA 92620-2058
(619) 433-9087
Mailing address
5200 IRVINE BLVD SPC 339, IRVINE, CA 92620-2058
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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