Individual
DR. THEODORE BLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2170 TOWNE CENTRE PLACE, #320, ANAHEIM, CA 92806
(714) 935-3042
(714) 935-3010
Mailing address
50 TALMONT, NEWPORT COAST, CA 92657
(949) 715-7313
(949) 715-7314
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G27506
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G27506
CA LICENSE NUMBER
CA
Enumeration date
04/22/2008
Last updated
04/22/2008
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