Individual
MR. RICHARD GARY BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.D.O.
Contact information
Practice address
21835 VENTURA BLVD, WOODLAND HILLS, CA 91364-1838
(818) 883-9567
(818) 883-5261
Mailing address
1086 DEEP WOOD DR, WESTLAKE VILLAGE, CA 91362-4215
(805) 495-4046
(808) 883-5261
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
D006638
CA
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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