Individual
BRIAN BLAISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2700 INTERNATIONAL BLVD, SUITE 11, OAKLAND, CA 94601-1520
(510) 533-1248
(510) 533-1870
Mailing address
2700 INTERNATIONAL BLVD, SUITE 11, OAKLAND, CA 94601-1520
(510) 533-1248
(510) 533-1870
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G64161
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G64161
STATE LICENSE NUMBER
CA
Enumeration date
07/26/2006
Last updated
07/09/2007
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