Individual
CRAIG BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1667 DOMINICAN WAY, STE 130, SANTA CRUZ, CA 95065-1529
(831) 462-9225
(831) 462-6285
Mailing address
1667 DOMINICAN WAY, STE 130, SANTA CRUZ, CA 95065-1529
(831) 462-9225
(831) 462-6285
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G52516
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G525160
—
CA
Enumeration date
05/24/2005
Last updated
08/26/2008
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