Individual
ERNEST KEITH POLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 W CALIFORNIA BLVD, PASADENA, CA 91105-3010
(626) 397-5000
(626) 397-2912
Mailing address
900 N ALMANSOR ST, ALHAMBRA, CA 91801-1127
(626) 289-7419
(626) 289-7419
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
C39853
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C398530
BLUE SHIELD
CA
05
—
00C398530
—
CA
Enumeration date
07/26/2006
Last updated
08/03/2010
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