Individual
DR. EDWARD BLACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 W JANSS ROAD, THOUSAND OAKS, CA 91360
(805) 373-8582
(805) 373-6865
Mailing address
2190 LYNN RD, STE 220, THOUSAND OAKS, CA 91360
(805) 495-8050
(805) 496-2160
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G49755
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G497750
—
CA
Enumeration date
02/27/2006
Last updated
02/16/2010
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