Organization
CARL I BLAU M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL I BLAU M D (OWNER)
(818) 886-6848
Entity
Organization
Contact information
Practice address
5400 BALBOA BLVD, #228, ENCINO, CA 91316-1502
(818) 886-6848
Mailing address
PO BOX 260710, ENCINO, CA 91426-0710
(818) 886-6848
(818) 886-0352
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A23803
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A238030
—
CA
Enumeration date
06/22/2010
Last updated
09/10/2010
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