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Individual

BRIAN WILLIAM BLAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2823 FRESNO ST, FRESNO, CA 93721-1324
(559) 443-2682
(559) 443-2681
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 443-2682
(559) 443-2681

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A132770
CA

Other

Enumeration date
04/03/2013
Last updated
09/06/2022
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