Individual
DAVID ALLEN BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 S LAKE AVE, SUITE 535, PASADENA, CA 91101-3005
(626) 795-6596
(626) 396-0851
Mailing address
225 S LAKE AVE, 535, PASADENA, CA 91101-3005
(626) 795-6596
(626) 795-8247
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A77088
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A770880
BLUE SHIELD
CA
05
—
00A770880
—
CA
Enumeration date
07/31/2006
Last updated
09/26/2023
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