Individual
BLAKE BUTLER SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
113 WATERWORKS WAY STE 300, IRVINE, CA 92618-3174
(949) 653-7000
Mailing address
113 WATERWORKS WAY STE 300, IRVINE, CA 92618-3174
(949) 653-7000
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
55738
KY
208200000X
Plastic Surgery Physician
Primary
A204050
CA
Other
Enumeration date
04/21/2015
Last updated
09/11/2025
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